不同时机宫腔镜检查对IVF-ET助孕患者妊娠结局的影响研究
Effect of Different Timing of Hysteroscopy on Pregnancy Outcomes in Patients Undergoing IVF-ET
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广州医药
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收稿时间:2026/6/11 8:49:46
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- 关键词:
- 宫腔镜;反复种植失败;体外受精-胚胎移植;临床妊娠率;检查时机
- Hysteroscopy; Recurrent implantation failure; In vitro fertilization-embryo transfer; Clinical pregnancy rate; Timing of examination
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目的:探讨不同时机宫腔镜检查对反复胚胎移植未孕患者后续体外受精-胚胎移植(IVF-ET)临床妊娠结局的影响。方法:回顾性分析2025年1月至2025年10月于东莞康华医院生殖医学科就诊的206例行IVF-ET助孕研究对象的临床资料。根据宫腔镜检查时机分为三组:A组(胚胎移植前检查,n=82)、B组(胚胎移植1次失败后检查,n=70)、C组(胚胎移植2次失败后检查,n=54)。比较三组研究对象后续IVF-ET周期的临床妊娠率。结果:三组研究对象基线年龄、不孕年限、BMI、AMH等指标差异无统计学意义(P>0.05)。总人群临床妊娠率为53.59%(97/206),其中A组妊娠率为72.0%(59/82),B组为35.7%(25/70),C组为24.1%(13/54),组间差异有统计学意义(P<0.001)。免疫双染阳性研究对象占86.27%(176/206),其在组间分布均衡,未改变主要结论。结论:对于IVF-ET助孕研究对象,胚胎移植前进行宫腔镜检查并处理异常,可能与后续临床妊娠率升高相关;延迟至1次或2次胚胎移植失败后再检查,妊娠获益可能大幅降低。提示胚胎移植前常规行宫腔镜评估的必要性。
Objective: To investigate the impact of different timing of hysteroscopy on the subsequent clinical pregnancy outcomes of patients with recurrent embryo transfer failure undergoing in vitro fertilization - embryo transfer (IVF-ET). Methods: The clinical data of 206 patients who underwent IVF-ET assisted pregnancy treatment at the Reproductive Medicine Department of Dongguan Kanghua Hospital from January 2025 to October 2025 were retrospectively analyzed. The patients were divided into three groups based on the timing of hysteroscopy: Group A (examined before embryo transfer, n = 82), Group B (examined after one failed embryo transfer, n = 70), and Group C (examined after two failed embryo transfers, n = 54). The clinical pregnancy rates of the subsequent IVF-ET cycles of the three groups were compared. Results: There were no statistically significant differences in baseline age, duration of infertility, BMI, AMH, etc. among the three groups (P > 0.05). The overall clinical pregnancy rate of the population was 53.59% (97/206), with the pregnancy rates in Group A being 72.0% (59/82), in Group B 35.7% (25/70), and in Group C 24.1% (13/54). The differences among the groups were statistically significant (P < 0.001). Immunobright staining positive study subjects accounted for 86.27% (176/206), and their distribution among the groups was balanced, without changing the main conclusion. Conclusion: For patients undergoing IVF-ET assisted pregnancy treatment, performing hysteroscopy and treating abnormalities before embryo transfer may be associated with an increased subsequent clinical pregnancy rate; delaying the examination until one or two failed embryo transfers may significantly reduce the pregnancy benefit. It suggests the necessity of routine hysteroscopy assessment before embryo transfer.
1、广东省医学科学技术研究基金项目(/upload/408188/20260608/20260608000942_4395.pdf)