Department of Obstetrics, Gynecology and Reproductive Sciences (Drs. Aharon, Sekhon, Ascher-Walsh, and Copperman), Icahn School of Medicine at Mount Sinai, New York, New York.
Department of Obstetrics, Gynecology and Reproductive Sciences (Drs. Aharon, Sekhon, Ascher-Walsh, and Copperman), Icahn School of Medicine at Mount Sinai, New York, New York; Reproductive Medicine Associates of New York (Drs. Sekhon, Ascher-Walsh, and Copperman andMr. Lee), New York, New York.
J Minim Invasive Gynecol. 2019 Sep-Oct;26(6):1083-1087.e1. doi: 10.1016/j.jmig.2018.10.019. Epub 2018 Oct 30.
Data are limited regarding optimal timing between operative hysteroscopy and embryo transfer (ET). This study aimed to assess whether the time interval from operative hysteroscopy to ET affects implantation and clinical pregnancy rates.
Retrospective cohort study (Canadian Task Force classification II-2).
Private academic center.
All patients who had operative hysteroscopy followed by a day 5 ET from 2012 to 2017.
Interval of time from operative hysteroscopy to ET.
The interval of time from hysteroscopy to ET was calculated, and linear regression analyses were performed to assess the impact on clinical outcome. A subanalysis of patients who underwent subsequent single, euploid, frozen ET(s) was performed. A total of 318 patients were included. Indications for hysteroscopy included polypectomy (n = 205), myomectomy (n = 36), lysis of adhesions (n = 46), septum resection (n = 19), and retained products of conception (n = 12). The mean interval of time from hysteroscopy to ET was 138.4 ± 162.7 days (range, 20-1390). There was no significant difference in mean interval of time between procedure and subsequent ET when comparing patients who achieved and did not achieve implantation. Patients stratified by interval of time from operative hysteroscopy to ET had similar clinical outcomes. The time interval from hysteroscopy had no impact on odds of implantation (odds ratio [OR], 1.001; 95% confidence interval [CI], .999-1.002; p = .49), ongoing pregnancy (OR, 1.001; 95% CI, .999-1.002; p = .42), or early pregnancy loss (OR, .997; 95% CI, .994-1.000; p = .07) (adjusted for oocyte age, recipient age, endometrial thickness, use of preimplantation genetic testing, use of donor egg, fresh vs frozen ET, ET count). Similar results were observed in the subanalysis restricted to euploid single frozen ETs from autologous cycles.
The time interval from operative hysteroscopy to subsequent ET does not impact the likelihood of successful clinical outcome. Patients who have undergone operative hysteroscopy do not need to delay fertility treatment.
关于手术宫腔镜检查和胚胎移植（ET）之间的最佳时间间隔的数据有限。本研究旨在评估手术宫腔镜检查到 ET 的时间间隔是否会影响着床和临床妊娠率。
回顾性队列研究（加拿大任务组分类 II-2）。
私立学术中心。
2012 年至 2017 年期间所有接受手术宫腔镜检查后行第 5 天 ET 的患者。
手术宫腔镜检查到 ET 的时间间隔。
计算了宫腔镜检查到 ET 的时间间隔，并进行线性回归分析以评估对临床结局的影响。对随后进行单次、整倍体、冷冻 ET（s）的患者进行了亚分析。共纳入 318 例患者。宫腔镜检查的适应证包括息肉切除术（n=205）、子宫肌瘤切除术（n=36）、粘连松解术（n=46）、纵隔切除术（n=19）和妊娠残留物切除术（n=12）。宫腔镜检查到 ET 的平均时间间隔为 138.4±162.7 天（范围 20-1390 天）。在比较着床和未着床的患者时，手术和随后的 ET 之间的平均时间间隔没有显著差异。按手术宫腔镜检查到 ET 的时间间隔分层的患者具有相似的临床结局。宫腔镜检查时间间隔对着床的可能性（比值比 [OR]，1.001；95%置信区间 [CI]，.999-1.002；p=0.49）、持续妊娠（OR，1.001；95%CI，.999-1.002；p=0.42）或早期妊娠丢失（OR，.997；95%CI，.994-1.000；p=0.07）均无影响（调整了卵母细胞年龄、受体年龄、子宫内膜厚度、使用植入前遗传学检测、使用供卵、新鲜 ET 与冷冻 ET、ET 计数）。在限制为自体周期的整倍体单个冷冻 ET 的亚分析中观察到了相似的结果。
手术宫腔镜检查到随后 ET 的时间间隔不会影响成功临床结局的可能性。接受过手术宫腔镜检查的患者不需要延迟生育治疗。
