体外受精中胚胎移植导管的污染与治疗结局
Contamination of embryo transfer catheter and treatment outcome in in vitro fertilization.
作者信息
Awonuga A, Nabi A, Govindbhai J, Birch H, Stewart B
机构信息
Midland Fertility Services, Aldridge, U.K.
出版信息
J Assist Reprod Genet. 1998 Apr;15(4):198-201. doi: 10.1023/a:1023000402789.
PURPOSE
The effect of embryo transfer (ET) catheter contamination with mucus and/or blood on treatment outcome in an in vitro fertilization (IVF) program was evaluated.
METHODS
One thousand four ET procedures in 877 patients having conventional IVF in the long (1189 cycle) and short (15 cycles) protocol were analyzed to determine the impact of catheter contamination on the incidence of retained embryos and the clinical pregnancy rate.
RESULTS
Catheter contamination with mucus and/or blood is a feature of difficult ET. Embryos were significantly more likely to be retained when the transfer catheter was contaminated with mucus (17.8 versus 3.3%) or blood (12 versus 3.3%). When the catheter was contaminated and an embryo(s) was retained and immediately retransferred, the pregnancy rate was not compromised. The pregnancy rate was significantly reduced when the ET catheter was contaminated with blood (15.5 versus 27.1%; P = 0.002), but no embryo was retained in the catheter set.
CONCLUSIONS
Catheter contamination compromises the treatment outcome in IVF only when there is no associated retained embryo(s). As increased vigilance in searching for extruded embryos may not be practical, we suggest that cervical mucus should be routinely aspirated and ET performed as atraumatically as possible.
目的
评估体外受精（IVF）程序中胚胎移植（ET）导管被黏液和/或血液污染对治疗结局的影响。
方法
分析了877例行常规IVF的患者在长方案（1189个周期）和短方案（15个周期）中的1400次ET操作，以确定导管污染对胚胎残留发生率和临床妊娠率的影响。
结果
导管被黏液和/或血液污染是困难ET的一个特征。当移植导管被黏液污染时（17.8%对3.3%）或被血液污染时（12%对3.3%），胚胎残留的可能性显著更高。当导管被污染且有胚胎残留并立即再次移植时，妊娠率不受影响。当ET导管被血液污染时（15.5%对27.1%；P = 0.002），妊娠率显著降低，但导管组中无胚胎残留。
结论
仅当没有相关胚胎残留时，导管污染才会损害IVF的治疗结局。由于提高寻找挤出胚胎的警惕性可能不切实际，我们建议应常规抽吸宫颈黏液，并尽可能无创地进行ET。
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