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既往异位妊娠治疗对体外受精-卵胞浆内单精子注射结局的影响:一项回顾性队列研究

Effect of treatment of a previous ectopic pregnancy on in vitro fertilization-intracytoplasmic sperm injection outcomes: a retrospective cohort study.

作者信息

Xu Zhen, Yan Lei, Liu Wen, Xu Xinxin, Li Miao, Ding Lingling, Ma Jinlong, Chen Zi-Jiang

机构信息

Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, Jinan; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan; Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China.

Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, Jinan; National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan; Key Laboratory for Reproductive Endocrinology of Ministry of Education, Jinan; Shandong Provincial Key Laboratory of Reproductive Medicine, Jinan, People's Republic of China.

出版信息

Fertil Steril. 2015 Dec;104(6):1446-51.e1-3. doi: 10.1016/j.fertnstert.2015.08.034. Epub 2015 Sep 25.

Abstract

OBJECTIVE

To evaluate the influence of previous ectopic pregnancies (EP) and different EP treatment methods on in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) outcomes.

DESIGN

Retrospective cohort study.

SETTING

University-based reproductive medicine center.

PATIENT(S): Women undergoing 51,268 fresh cycles of IVF-ICSI.

INTERVENTION(S): In women who had had an EP before the IVF treatment and women who were diagnosed with fallopian disease without an EP (control group), division into three treatment subgroups: subgroup 1, conservative treatment; subgroup 2, salpingostomy; and subgroup 3 salpingectomy.

MAIN OUTCOME MEASURE(S): Estimates of IVF-ICSI outcome and ovarian function based on number of antral follicles and rates of implantation, EP, clinical pregnancy, and delivery.

RESULT(S): For the experimental group and the control group, there were no statistically significant differences in the rates of implantation, clinical pregnancy, or delivery. However, the risk of recurrent EP was statistically significantly higher in the experimental group compared with the control group. There were no statistically significant differences in IVF-ICSI outcomes between the three treatment subgroups in terms of the basic antral follicle number or the dominant antral follicle numbers (>1.0 cm) after surgical treatment of EP.

CONCLUSION(S): Our results suggest that women with a prior history of EP have a higher recurrence risk of EP after IVF in comparison with women with no history of EP. Previous EP has no effect on the main IVF-ICSI outcomes. For the treatment of EP, salpingostomy and salpingectomy do not statistically significantly affect ovarian function.

摘要

目的

评估既往异位妊娠(EP)及不同EP治疗方法对体外受精-卵胞浆内单精子注射(IVF-ICSI)结局的影响。

设计

回顾性队列研究。

地点

大学附属生殖医学中心。

患者

接受51268个新鲜周期IVF-ICSI的女性。

干预措施

将IVF治疗前有EP病史的女性以及被诊断为输卵管疾病但无EP病史的女性(对照组)分为三个治疗亚组:亚组1,保守治疗;亚组2,输卵管造口术;亚组3,输卵管切除术。

主要观察指标

根据窦卵泡数量、着床率、EP、临床妊娠率和分娩率评估IVF-ICSI结局及卵巢功能。

结果

实验组和对照组在着床率、临床妊娠率或分娩率方面无统计学显著差异。然而,与对照组相比,实验组复发性EP的风险在统计学上显著更高。在EP手术治疗后,三个治疗亚组在基础窦卵泡数量或优势窦卵泡数量(>1.0 cm)方面的IVF-ICSI结局无统计学显著差异。

结论

我们的结果表明,与无EP病史的女性相比,有EP病史的女性在IVF后发生EP的复发风险更高。既往EP对主要IVF-ICSI结局无影响。对于EP的治疗,输卵管造口术和输卵管切除术对卵巢功能无统计学显著影响。

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