Triantafyllidou Olga, Korompokis Ilias, Chasiakou Stamatia, Bakas Panagiotis, Kalampokas Theodoros, Simopoulou Mara, Tzanakaki Despoina, Kalampokas Emmanouil, Panagodimou Evangelia, Xepapadaki Maria, Christopoulos Panagiotis, Valsamakis Georgios, Vlahos Nikolaos F
2nd Department of Obstetrics and Gynaecology, Aretaieio Hospital, National and Kapodistrian University of Athens, Vas. Sofias Str. 76, 11528 Athens, Greece.
Hippocratio General Hospital of Athens, Greece V. Sofias 114, 11527 Athens, Greece.
J Clin Med. 2024 Aug 13;13(16):4755. doi: 10.3390/jcm13164755.
To assess the effect of hysteroscopic polypectomy on the in vitro fertilization (IVF) results in infertile women with at least one prior negative IVF outcome. This retrospective cohort study included women who had attended the "2nd Department of Obstetrics and Gynecology of the National and Kapodistrian University of Athens" and "Iaso" Maternity Hospital from October 2019 to January 2023 for infertility treatment. The medical records of 345 women aged 18-45 years old without abnormal findings in hysterosalpingography (HSG) and with at least one previous failed IVF procedure were analyzed. The male factor was excluded, as well as a prior hysteroscopic removal of polyps. In 67 women, polyps were suspected during initial two-dimensional ultrasound (2D-US) examination. The final sample of the study comprised 40 patients, in which endometrial polyps were removed by hysteroscopy with the use of resectoscope. All patients underwent ovarian stimulation and IVF in the consecutive cycle using a short GnRh antagonist protocol. After hysteroscopic polypectomy, 29 (72.5%) out of 40 patients had a positive pregnancy result: 26 (65%) clinical and 3 (7.5%) biochemical pregnancies were documented. There was a statistically significant difference between the number of clinical pregnancies before and after polypectomy ( < 0.001), as well as between the total number of pregnancies ( < 0.001). : Women with positive outcome were significantly younger and had significantly lower FSH levels ( < 0.007). They also had significantly higher AMH ( < 0.009) and peak estradiol levels ( < 0.013) and yielded more M II oocytes ( < 0.009) and embryos ( < 0.002). Hysteroscopic polypectomy in women with a suspected endometrial polyp using 2D ultrasound and a history of prior failed IVF attempt improves IVF outcomes in terms of the clinical and total number of pregnancies.
评估宫腔镜下息肉切除术对既往至少有一次体外受精（IVF）失败结果的不孕女性IVF结局的影响。这项回顾性队列研究纳入了2019年10月至2023年1月期间在“雅典国立与卡波迪斯特里亚大学第二妇产科”和“亚索”妇产医院接受不孕治疗的女性。分析了345名年龄在18 - 45岁、子宫输卵管造影（HSG）无异常发现且既往至少有一次IVF程序失败的女性的病历。排除男性因素以及既往宫腔镜下息肉切除术史。67名女性在初次二维超声（2D-US）检查时怀疑有息肉。研究的最终样本包括40名患者，其中通过宫腔镜使用电切镜切除子宫内膜息肉。所有患者在连续周期中使用短效GnRh拮抗剂方案进行卵巢刺激和IVF。宫腔镜下息肉切除术后，40名患者中有29名（72.5%）获得阳性妊娠结果：记录到26例（65%）临床妊娠和3例（7.5%）生化妊娠。息肉切除术前和术后临床妊娠数量之间存在统计学显著差异（<0.0B01），妊娠总数之间也存在统计学显著差异（<0.0B01）。妊娠结局为阳性的女性明显更年轻，促卵泡生成素（FSH）水平明显更低（<0.007）。她们的抗缪勒管激素（AMH）（<0.009）和雌二醇峰值水平（<0.013）也明显更高，产生的MⅡ期卵母细胞（<0.009）和胚胎（<0.002）更多。对于怀疑有子宫内膜息肉且既往有IVF失败史的女性，使用二维超声进行宫腔镜下息肉切除术可改善临床妊娠和妊娠总数方面的IVF结局。 （注：原文中部分统计值处出现乱码，已保留原文格式）
