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经小切口剖腹输卵管内配子移植术与体外受精和胚胎移植术的临床疗效比较

The clinical efficacy of gamete intrafallopian transfer by minilaparotomy versus in vitro fertilization and embryo transfer.

作者信息

Sayama M, Araki S, Motoyama M, Tamada T, Sato I

机构信息

Department of Obstetrics and Gynecology, Jichi Medical School, Tochigi, Japan.

出版信息

J Obstet Gynaecol Res. 1996 Oct;22(5):409-16. doi: 10.1111/j.1447-0756.1996.tb01049.x.

Abstract

OBJECTIVE

To evaluate the clinical performance of gamete intrafallopian transfer (GIFT) and in vitro fertilization and embryo transfer (IVF-ET).

METHODS

Infertile women were divided into 2 groups: for GIFT, 239 patients (326 cycles) with at least 1 patent tube; and, for IVF-ET, 125 patients (210 cycles) with bilateral tubal occlusion. A specially designed retractor was developed to replace the gametes into an appropriate section of the Fallopian tube accurately and safely. Several parameters, including the pregnancy and delivery rates of each group, were compared.

RESULTS

The success rate per trial in the GIFT group was approximately 1.5 times higher than that in the IVF group (pregnancy rate: 44.2% vs. 31.0%, p < 0.01; delivery rate: 33.4% vs. 22.9%, p < 0.01). The pregnancy and delivery rates of GIFT decreased steadily with the number of trials. These apparent decreases were not observed up to the 3rd trial in IVF-ET cases.

CONCLUSIONS

GIFT with a minilaparotomy procedure yielded significantly higher success rates than IVF-ET. Accordingly, GIFT is considered to be the first treatment choice in infertility cases with at least 1 patent Fallopian tube.

摘要

目的

评估配子输卵管内移植(GIFT)和体外受精-胚胎移植(IVF-ET)的临床效果。

方法

将不孕妇女分为两组:GIFT组,239例患者(326个周期),至少有1条输卵管通畅;IVF-ET组,125例患者(210个周期),双侧输卵管阻塞。研发了一种特殊设计的牵开器,以准确、安全地将配子植入输卵管的适当部位。比较了包括每组的妊娠率和分娩率在内的几个参数。

结果

GIFT组每次试验的成功率比IVF组高约1.5倍(妊娠率:44.2%对31.0%,p<0.01;分娩率:33.4%对22.9%,p<0.01)。GIFT的妊娠率和分娩率随着试验次数的增加而稳步下降。在IVF-ET病例中,直到第3次试验都未观察到这种明显的下降。

结论

采用小切口剖腹术的GIFT成功率明显高于IVF-ET。因此,GIFT被认为是至少有1条输卵管通畅的不孕病例的首选治疗方法。

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