Department of Obstetrics and Gynecology, Graduate School of Medicine, Mie University, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan.
Department of Obstetrics and Gynecology, Mie University Hospital, 2-174 Edo-bashi, Tsu, Mie 514-8507, Japan.
Medicina (Kaunas). 2023 Oct 20;59(10):1868. doi: 10.3390/medicina59101868.
: A relationship between endometrial polypectomy and in vitro fertilization (IVF) pregnancy outcomes has been reported; however, only a few studies have compared polyp removal techniques and pregnancy rates. We investigated whether different polypectomy techniques with endometrial curettage and hysteroscopic polypectomy for endometrial polyps affect subsequent pregnancy outcomes. : Data from 434 patients who had undergone polypectomy for suspected endometrial polyps using transvaginal ultrasonography before embryo transfer in IVF at four institutions between January 2017 and December 2020 were retrospectively analyzed. Overall, there were 157 and 277 patients in the hysteroscopic (mean age: 35.0 years) and curettage (mean age: 37.3 years) groups, respectively. Single-blastocyst transfer cases were selected from both groups and age-matched to unify background factors. : In the single-blastocyst transfer cases, 148 (mean age: 35.0 years) and 196 (mean age: 35.9 years) were in the hysteroscopic and curettage groups, respectively, with the 148 cases matched by age. In these cases, the pregnancy rates for the first embryo transfer were 68.2% (odds ratio (OR): 2.14) and 51.4% (OR: 1.06) in the hysteroscopic and curettage groups, respectively; the resulting OR was 2.03. The pregnancy rates after up to the second transfer were 80.4% (OR: 4.10) and 68.2% (OR: 2.14) in the hysteroscopic and curettage groups, respectively, in which the OR was 1.91. The live birth rates were 66.2% (OR: 1.956) and 53.4% (OR: 1.15) in the hysteroscopic and curettage groups, respectively, in which the odds ratio was 1.71. These results show the effectiveness of hysteroscopic endometrial polypectomy compared to polypectomy with endometrial curettage. No significant difference was found regarding the miscarriage rates between the two groups. : Hysteroscopic endometrial polypectomy resulted in a higher pregnancy rate in subsequent embryo transfer than polypectomy with endometrial curettage. Therefore, establishing a facility where polypectomy can be performed hysteroscopically is crucial.
息肉切除术与体外受精（IVF）妊娠结局之间存在一定关系，但仅有少数研究比较了息肉切除技术和妊娠率。我们旨在研究经阴道超声检查怀疑子宫内膜息肉的患者在 IVF 胚胎移植前行子宫内膜息肉切除术时，采用刮宫术与宫腔镜息肉切除术对后续妊娠结局的影响。
回顾性分析了 2017 年 1 月至 2020 年 12 月 4 家机构中经阴道超声检查怀疑子宫内膜息肉的 434 例患者的资料，这些患者在 IVF 胚胎移植前行息肉切除术。宫腔镜组（平均年龄：35.0 岁）和刮宫组（平均年龄：37.3 岁）患者分别为 157 例和 277 例。从两组中分别选择单囊胚移植病例，并进行年龄匹配以统一背景因素。
在单囊胚移植病例中，宫腔镜组和刮宫组分别为 148 例（平均年龄：35.0 岁）和 196 例（平均年龄：35.9 岁），其中宫腔镜组 148 例进行年龄匹配。这些病例中，第一次胚胎移植的妊娠率分别为宫腔镜组 68.2%（比值比（OR）：2.14）和刮宫组 51.4%（OR：1.06）；OR 为 2.03。第二次及以后的胚胎移植妊娠率分别为宫腔镜组 80.4%（OR：4.10）和刮宫组 68.2%（OR：2.14），OR 为 1.91。活产率分别为宫腔镜组 66.2%（OR：1.956）和刮宫组 53.4%（OR：1.15），OR 为 1.71。这些结果表明，与刮宫术相比，宫腔镜下子宫内膜息肉切除术在后续胚胎移植中具有更高的妊娠率。因此，建立一个可以进行宫腔镜息肉切除术的设施至关重要。
两组间流产率无显著差异。
