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宫腔镜检查对体外受精(IVF)第一周期活产率的影响。

The effect of performing hysteroscopy prior to the first in vitro fertilization (IVF) cycle on live birth rate.

机构信息

a Department of Obstetrics and Gynecology , Hacettepe University School of Medicine , Ankara , Turkey.

出版信息

Gynecol Endocrinol. 2019 May;35(5):443-447. doi: 10.1080/09513590.2018.1534953. Epub 2019 Jan 6.

Abstract

In this retrospective cohort study, a total of 707 couples underwent in vitro fertilization (IVF) at Hacettepe University Hospital between 01 January 2010 and 01 November 2014 with their chronologically first cycle were evaluated. Patients who have diagnostic hysteroscopy prior to first IVF cycle served as a study group (n = 42) and patients without diagnostic hysteroscopy served as control group (n = 282). In study group in all patients, diagnostic hysteroscopy was performed at the follicular phase of previous menstrual cycle, namely immediately before ovarian stimulation (OS) cycle. Demographic features, clinical characteristics and treatment outcomes were compared between the groups. The logistic regression analysis was performed in order to assess independent predictors of live birth rates (LBRs). There was no statistically significant difference between the groups for demographic features and OS cycle characteristics. Implantation rate (22.2% vs. 21.5%, p=.840), clinical pregnancy rate (33.3% vs. 28.7%, p=.541), and LBRs (23.8% vs. 18.5%, p=.420) were comparable. In logistic regression analysis, performing hysteroscopy prior to first IVF cycles per se without correcting anatomic abnormalities was not an independent predictor of LBRs (OR: 0.72, 95% CI: 0.310-1.68, p=.45). In conclusion, performing diagnostic hysteroscopy prior to first IVF treatment cycle without correcting any anatomic abnormalities did not improve LBRs.

摘要

在这项回顾性队列研究中,共有 707 对夫妇于 2010 年 1 月 1 日至 2014 年 11 月 1 日在哈塞特佩大学医院进行了首次体外受精(IVF)周期,对这些夫妇进行了评估。在首次 IVF 周期前进行诊断性宫腔镜检查的患者作为研究组(n=42),未进行诊断性宫腔镜检查的患者作为对照组(n=282)。在研究组中,所有患者均在月经周期的卵泡期,即卵巢刺激(OS)周期前进行诊断性宫腔镜检查。比较了两组之间的人口统计学特征、临床特征和治疗结局。为了评估活产率(LBR)的独立预测因素,进行了逻辑回归分析。两组之间的人口统计学特征和 OS 周期特征无统计学差异。两组的种植率(22.2%比 21.5%,p=0.840)、临床妊娠率(33.3%比 28.7%,p=0.541)和 LBR(23.8%比 18.5%,p=0.420)相似。在逻辑回归分析中,首次 IVF 周期前进行宫腔镜检查本身,而不纠正解剖异常,并不是 LBR 的独立预测因素(OR:0.72,95%CI:0.310-1.68,p=0.45)。总之,在首次 IVF 治疗周期前进行诊断性宫腔镜检查,而不纠正任何解剖异常,并不能提高 LBR。

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