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门诊宫腔镜下子宫内膜息肉切除术对受精/卵胞浆内单精子注射治疗周期妊娠率的影响:25例系列研究

The Effect of Endometrial Polyp Resection by Office Hysteroscopy during Fertilization/Intracytoplasmic Sperm Injection Treatment Cycle on Pregnancy Rate A Series of 25 Cases.

作者信息

Al Rshoud Firas, Kilani Rami, Al Asali Fida, Assi Omar, Ikhlaif Nedaa, Maaita Ward

机构信息

Department of Reproductive Medicine and Infertility, Obstetrics and Gynecology, Faculty of Medicine, The Hashemite University, Zarqa, Jordan.

Department of Faculty of Medicine, The University of Jordan, Amman, Jordan.

出版信息

J Hum Reprod Sci. 2021 Oct-Dec;14(4):439-442. doi: 10.4103/jhrs.jhrs_14_21. Epub 2021 Dec 31.

Abstract

AIM

This study aims to evaluate the effect of endometrial polyp resection by office hysteroscopy during fertilisation/intracytoplasmic sperm injection (IVF/ICSI) treatment cycle on pregnancy rate.

SETTING AND DESIGN

A retrospective observational study (case series).

MATERIALS AND METHODS

Twenty-five patients from a total of 346 patients that started IVF/ICSI treatment due to different causes of infertility over the period from January 2018 to December 2019 underwent an office hysteroscopy during ovarian stimulation (day 7-8) due to suspected endometrial polyp by transvaginal ultrasound and confirmed at day 7 of ovarian stimulation were retrospectively investigated.

RESULTS

Eighteen patients from the 25 patients that started IVF/ICSI treatment; endometrial polyp was confirmed by office hysteroscopy and resected, egg collection performed after 4-5 days after the hysteroscopy, embryo transfer done Double ET) at Day 3 and 5, the clinical Pregnancy rate was 56% (10 from the 18). No hysteroscopy-related adverse events were reported.

CONCLUSION

Office hysteroscopy during ovarian stimulation in the IVF/ICSI treatment cycle may be useful in confirming the diagnosis and resection of endometrial polyp suspected by transvaginal ultrasound and is safe on the endometrium in terms of receptivity and improvement of the pregnancy rate. As the sample size of our study is relatively small, a well-designed large RCT is required to confirm our results before clinical advice is released.

摘要

目的

本研究旨在评估在体外受精/卵胞浆内单精子注射(IVF/ICSI)治疗周期中,门诊宫腔镜下子宫内膜息肉切除术对妊娠率的影响。

设置与设计

一项回顾性观察研究(病例系列)。

材料与方法

回顾性调查了2018年1月至2019年12月期间因不同原因不孕而开始IVF/ICSI治疗的346例患者中的25例。这些患者在卵巢刺激期间(第7 - 8天)因经阴道超声怀疑有子宫内膜息肉而接受了门诊宫腔镜检查,并在卵巢刺激第7天得到确诊。

结果

25例开始IVF/ICSI治疗的患者中有18例;经门诊宫腔镜检查确诊并切除了子宫内膜息肉,宫腔镜检查后4 - 5天进行取卵,在第3天和第5天进行胚胎移植(双胚胎移植),临床妊娠率为56%(18例中的10例)。未报告与宫腔镜检查相关的不良事件。

结论

在IVF/ICSI治疗周期的卵巢刺激期间进行门诊宫腔镜检查,可能有助于确诊经阴道超声怀疑的子宫内膜息肉并将其切除,就子宫内膜容受性和提高妊娠率而言,对子宫内膜是安全的。由于我们研究的样本量相对较小,在发布临床建议之前,需要设计良好的大型随机对照试验来证实我们的结果。

相似文献

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Management of endometrial polyps diagnosed before or during ICSI cycles.经 ICSI 周期前或周期中诊断的子宫内膜息肉的处理。
Reprod Biomed Online. 2012 Jan;24(1):123-8. doi: 10.1016/j.rbmo.2011.09.002. Epub 2011 Sep 16.

本文引用的文献

1
Endometrial Polyps and Subfertility.子宫内膜息肉与生育力低下
J Obstet Gynaecol India. 2017 Feb;67(1):9-14. doi: 10.1007/s13224-016-0929-4. Epub 2016 Aug 20.
7
The uterus and fertility.子宫与生育能力。
Fertil Steril. 2008 Jan;89(1):1-16. doi: 10.1016/j.fertnstert.2007.09.069. Epub 2007 Dec 21.
8
Location of endometrial polyp and pregnancy rate in infertility patients.子宫内膜息肉的位置与不孕患者的妊娠率
Fertil Steril. 2008 Jul;90(1):180-2. doi: 10.1016/j.fertnstert.2007.05.072. Epub 2007 Sep 24.

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