Yang Jehn-Hsiahn, Yang Po-Kai, Chen Mei-Jou, Chen Shee-Uan, Yang Yu-Shih
Department of Obstetrics and Gynecology, National Taiwan University Hospital, 7 Chung-Shan South Road, 100, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Obstetrics and Gynecology, National Taiwan University Hospital, 7 Chung-Shan South Road, 100, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Reprod Biomed Online. 2017 Mar;34(3):285-290. doi: 10.1016/j.rbmo.2016.12.012. Epub 2016 Dec 21.
An endometrial polyp is a frequently encountered abnormality of the uterine cavity that may interfere with normal embryo implantation. In this case-control study, we enrolled 56 women in whom endometrial polyps were incidentally diagnosed by transvaginal ultrasound and office hysteroscopy during IVF (Group 1), and 112 age-matched IVF controls randomly selected from the same time period (group 2). Cryopreserved embryos were transferred in group 1 whereas fresh embryos were transferred in group 2, which is a limitation of the study. Hysteroscopic polypectomy was carried out for those in group 1, followed by vitrified-warmed embryo transfer 1-7 months later. Results revealed that the clinical pregnancy rate was higher in group 1 than in group 2 (63% versus 41%, P = 0.009), but the embryo implantation rates were not different between the two groups (26% versus 20%). In group 1, pregnancy rates (64%, 69%, and 53% respectively) and embryo implantation rates (30%, 24%, and 23%, respectively) were similar among women that received vitrified-warmed embryo transfer at 1, 2, and 3 months or over after hysteroscopic polypectomy. We conclude that, for women with endometrial polyps incidentally diagnosed during IVF, pregnancy outcomes are not compromised after hysteroscopic polypectomy followed by vitrified-warmed embryo transfer.
子宫内膜息肉是子宫腔内常见的异常情况，可能会干扰正常的胚胎着床。在这项病例对照研究中，我们纳入了56名在体外受精（IVF）期间经阴道超声和门诊宫腔镜检查偶然诊断出子宫内膜息肉的女性（第1组），以及从同一时期随机选取的112名年龄匹配的IVF对照者（第2组）。第1组移植冷冻胚胎，而第2组移植新鲜胚胎，这是本研究的一个局限性。对第1组患者进行宫腔镜息肉切除术，然后在1至7个月后进行玻璃化冷冻胚胎移植。结果显示，第1组的临床妊娠率高于第2组（63%对41%，P = 0.009），但两组的胚胎着床率没有差异（26%对20%）。在第1组中，接受宫腔镜息肉切除术后1、2和3个月或更长时间进行玻璃化冷冻胚胎移植的女性，其妊娠率（分别为64%、69%和53%）和胚胎着床率（分别为30%、24%和23%）相似。我们得出结论，对于在IVF期间偶然诊断出子宫内膜息肉的女性，宫腔镜息肉切除术后进行玻璃化冷冻胚胎移植不会影响妊娠结局。
