Zhang Bingqian, Cao Lianbao, Ding Lingling, Yan Lei, Chen Zi-Jiang
Center for Reproductive Medicine, Shandong University, Jinan, China.
National Research Center for Assisted Reproductive Technology and Reproductive Genetics, Jinan, China.
Gynecol Minim Invasive Ther. 2017 Jul-Sep;6(3):103-107. doi: 10.1016/j.gmit.2017.01.001. Epub 2017 Feb 3.
To evaluate the effects of different treatment methods for previous ectopic pregnancies (EP) on cryopreserved embryo transfer (CET) outcomes.
This was a retrospective cohort study. Patients with EP histories were divided into four groups based on their previous EP treatments: Group 1-unilateral tubal removal; Group: 2-bilateral tubal removal or unilateral tubal removal with contralateral tubal ligation; Group: 3-conservative surgery group; and Group 4-conservative medication group. A total of 1333 women with previous histories of being admitted to the hospital for CET treatment were consecutively enrolled between January 2009 and December 2014.
Patients who underwent bilateral tubal ligation or removal had a lower miscarriage rate [8.88% vs. 3.46%, = 0.006, odds ratio = 2.718, 95% confidence interval (CI) = 1.301-5.677] than those who underwent unilateral tubal removal. No significant difference was observed in the rate of EP after CET in the four groups in women with EP histories. ( = 0.258, 95%CI = 0.113-1.836; = 0.137, 95%CI = 0.975-0.997; = 0.314, 95%CI = 0.987-1.001; = 0.198, 95%CI = 0.987-1.001). The groups were not different with regard to other pregnancy outcomes.
There was no significant difference among EP treatment methods with regard to their impacts on CET outcomes in women with EP histories. Bilateral tubal ligation or removal surgery can decrease the miscarriage rate after CET.
评估既往异位妊娠（EP）的不同治疗方法对冻融胚胎移植（CET）结局的影响。
这是一项回顾性队列研究。有EP病史的患者根据其既往EP治疗方法分为四组：第1组——单侧输卵管切除；第2组——双侧输卵管切除或单侧输卵管切除加对侧输卵管结扎；第3组——保守手术组；第4组——保守药物治疗组。2009年1月至2014年12月期间，连续纳入了1333例既往因CET治疗入院的女性。
接受双侧输卵管结扎或切除的患者流产率[8.88%对3.46%，P = 0.006，比值比 = 2.718，95%置信区间（CI）= 1.301 - 5.677]低于接受单侧输卵管切除的患者。有EP病史的女性中，四组患者在CET后发生EP的比率无显著差异（P = 0.258，95%CI = 0.113 - 1.836；P = 0.137，95%CI = 0.975 - 0.997；P = 0.314，95%CI = 0.987 - 1.001；P = 0.198，95%CI = 0.987 - 1.001）。在其他妊娠结局方面，各组之间无差异。
对于有EP病史的女性，EP治疗方法对CET结局的影响无显著差异。双侧输卵管结扎或切除手术可降低CET后的流产率。
