부산대학교 도서관

目的 探讨既往自然流产次数对首次体外受精或卵母细胞胞质内单精子注射法(IVF/ICSI)治疗结局的影响.方法 回顾性病例对照研究分析天津市中心妇产医院2014年7月至2018年7月首次行IVF/ICSI治疗共1 279例患者的临床资料,按既往自然流产次数分为0次组(n=924)、1次组(n=267)、2次组(n=88)进行比较.结果 0次组、1次组、2次组患者的年龄、基础睾酮、雌二醇、孕酮、催乳素水平以及胚胎质量(优质胚胎率、正常受精数)均无差异(P均>0.05).2次组患者的生化妊娠率(9.1%)较其他两组(4.1%、4.1%)高,但分别比较,差异均无统计学意义(P均>0.05).临床妊娠率0次组(42.5%)>1次组(40.4%)>2次组(35.2%),但差异均无统计学意义(P均>0.05).早期流产率0次组(8.9%)<1次组(15.7%)<2次组(38.7%),分别比较,差异均有统计学意义(P均<0.05).2次组患者的活产率(21.6%)较0次组(35.5%)下降明显(P<0.05),但与1次组(30.7%)比较,差异无统计学意义(P>0.05).结论 既往1次、2次自然流产史对胚胎质量无明显影响,对首次IVF/ICSI治疗的临床妊娠率、早期流产率、活产率有一定的负面影响;尤其是既往2次自然流产史的患者,早期流产率显著增加、活产率显著下降,建议对既往2次自然流产史患者再次妊娠前按照复发性流产的检查流程查找病因,必要时给予预处理.
Objective To investigate the effect of the number of previous spontaneous abortions on the first in vitro fertilization or intracytoplasmic sperm injection (IVF/ICSI) cycle. Methods A retrospective case?control study was conducted to analyze the clinical data of 1 279 patients who received IVF/ICSI treatment for the first time from July 2014 to July 2018 in Tianjin Central Hospital of Gynecology Obstetrics;they were divided into 0 time group (group A, n=924), 1 time group (group B, n=267) and 2 times group (group C, n=88) for comparison, according to the previous frequency of spontaneous abortions. Results There were no statistically significant differences in age, basal testosterone, estradiol, progesterone, prolactin and embryo quality in group A, B and C (all P>0.05). The biochemical pregnancy rate of group C (9.1%) was higher than those of the other two groups (4.1% and 4.1%; all P>0.05). The clinical pregnancy rate of group A (42.5%) [>group B (40.4%) and>group C (35.2%)] was not statistically significant(P>0.05).Early abortion rate in group A (8.9%) was0.05). Conclusions Women with a history of one? or two?time spontaneous abortion have no obvious effect on embryo quality, and have a negative impact of clinical pregnancy rate, early abortion rate, live birth rate in the first IVF/ICSI cycle; especially for patients with a history of two times spontaneous abortion, early abortion rate has a significant increase, live birth rate decreases significantly, suggesting that patients with a history of two times of spontaneous abortion should find the causes of miscarriage according to the process of recurrent spontaneous miscarriage and receive treatment if necessary before subsequent pregnancy.