Peitsidis Nikolaos, Tsakiridis Ioannis, Najdecki Robert, Michos Georgios, Chouliara Foteini, Timotheou Evi, Chartomatsidou Tatiana, Athanasiadis Apostolos, Papanikolaou Evangelos
Assisting Nature Centre of Reproduction and Genetics, Thessaloniki, Greece.
Third Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece.
JBRA Assist Reprod. 2023 Nov 14;27(4):689-93. doi: 10.5935/1518-0557.20230037.
This study aimed to investigate whether hysteroscopy plus endometrial fundal incision (EFI) with endoscopic scissors can improve reproductive outcomes in oocyte recipients who have failed in their first egg donation cycle.
This was a prospective study (2014-2022) conducted in Assisting Nature Centre Reproduction and Genetics, Thessaloniki Greece, IVF Unit. The study population consisted of oocyte recipients with implantation failure in their first embryo transfer (ET) with donor eggs. All the recipients underwent routine evaluation during their early follicular phase, 1-3 months before the start of a new cycle with donor oocytes and were eligible to undergo EFI.
During the study period, 218 egg recipients underwent egg donation; 126 out of 218 oocyte recipients (57.8%) did not achieve a live birth at the 1st ET. 109 of them had surplus embryos cryopreserved and underwent a second ET; 50 women consented for EFI. Both groups were similar in terms of age, years of infertility, duration of estrogen replacement protocol and number of transferred blastocysts (p>0.05). In the EFI group, 60% had normal intrauterine cavity, while 40% had minor anomalies. The pregnancy test was positive in 46% (n=23/50) in the EFI group compared with 27.1% (n=16/59) in the control group (p=0.04). Moreover, live birth rates were higher in the EFI group compared to the control group (38.0% vs. 20.3%; p=0.04).
The findings of our study indicate that in oocyte recipients after implantation failure, diagnostic hysteroscopy plus EFI prior to subsequent ETmay increase pregnancy and live birth rates.
本研究旨在探讨宫腔镜检查联合使用内镜剪刀行子宫内膜底部切开术（EFI）是否能改善首次卵子捐赠周期失败的卵母细胞受者的生殖结局。
这是一项前瞻性研究（2014 - 2022年），在希腊塞萨洛尼基辅助自然中心生殖与遗传学体外受精科进行。研究人群包括首次胚胎移植（ET）使用供体卵子但植入失败的卵母细胞受者。所有受者在卵泡早期、开始新的供体卵母细胞周期前1 - 3个月接受常规评估，且符合行EFI的条件。
在研究期间，218名卵子受者接受了卵子捐赠；218名卵母细胞受者中有126名（57.8%）在首次ET时未实现活产。其中109名有冷冻保存的多余胚胎并接受了第二次ET；50名女性同意行EFI。两组在年龄、不孕年限、雌激素替代方案持续时间和移植囊胚数量方面相似（p>0.05）。在EFI组中，60%的子宫腔内正常，40%有轻微异常。EFI组妊娠试验阳性率为46%（n = 23/50），而对照组为27.1%（n = 16/59）（p = 0.04）。此外，EFI组的活产率高于对照组（38.0%对20.3%；p = 0.04）。
我们的研究结果表明，对于植入失败后的卵母细胞受者，在后续ET前进行诊断性宫腔镜检查联合EFI可能会提高妊娠率和活产率。
