Guo Ju Shi, Huang Yi, Liu Yong Mei, Gu Tian Jin, Yuan Jin Jin, Yang Yuan
The First Clinical Medical College Lanzhou University Lanzhou China.
Department of Centre for Reproductive Medicine The First Hospital of Lanzhou University Lanzhou China.
Reprod Med Biol. 2025 Sep 10;24(1):e12677. doi: 10.1002/rmb2.12677. eCollection 2025 Jan-Dec.
Compare reproductive outcomes between patients with subtle distal fallopian tube abnormalities (SDFTA) and unexplained infertility (UI) undergoing in vitro fertilization (IVF), exploring influencing factors.
This retrospective study analyzed 447 women undergoing their first IVF cycle after laparoscopic evaluation for UI between January 2019 and December 2021. Based on laparoscopic findings, 162 women were classified into the SDFTA group and 285 into the UI group. Propensity score matching (PSM) created 160 matched pairs. The primary outcome was the cumulative live birth rate (CLBR) over 24 months.
The CLBR per oocyte retrieval cycle, biochemical pregnancy rate, clinical pregnancy rate, live birth rate per transfer, and preterm birth rate were comparable between the two groups ( > 0.05). However, the SDFTA group had a significantly lower early miscarriage rate (8.3% vs. 16.1%, = 0.036) but a higher ectopic pregnancy rate (5.8% vs. 1.3%, = 0.033). Independent predictors of CLBR were age at retrieval, the number of oocytes retrieved, and the number of IVF cycles.
In conclusion, despite an increased risk of ectopic pregnancy, patients with SDFTA undergoing IVF exhibit favorable cumulative reproductive outcomes.
比较接受体外受精（IVF）的远端输卵管微小异常（SDFTA）患者和不明原因不孕症（UI）患者的生殖结局，探讨影响因素。
这项回顾性研究分析了2019年1月至2021年12月间因不明原因不孕症接受腹腔镜评估后进行首次IVF周期的447名女性。根据腹腔镜检查结果，162名女性被分为SDFTA组，285名女性被分为UI组。倾向评分匹配（PSM）产生了160对匹配对。主要结局是24个月内的累积活产率（CLBR）。
两组间每个取卵周期的CLBR、生化妊娠率、临床妊娠率、每次移植的活产率和早产率相当（>0.05）。然而，SDFTA组的早期流产率显著较低（8.3%对16.1%，=0.036），但异位妊娠率较高（5.8%对1.3%，=0.033）。CLBR的独立预测因素是取卵时的年龄、取卵数量和IVF周期数。
总之，尽管异位妊娠风险增加，但接受IVF的SDFTA患者仍表现出良好的累积生殖结局。
