目的 探讨不影响宫腔形态的肌壁间子宫肌瘤对体外受精-胚胎移植(IVF-ET)妊娠结局的影响及随访观察.方法 选取于生殖中心行IVF-ET,不孕合并超声检查示不影响宫腔形态的肌壁间子宫肌瘤患者91例,共行胚胎移植100个周期(观察组),抽取同期行IVF-ET治疗的单纯输卵管性不孕不合并子宫肌瘤患者100例(对照组).对两组的一般情况、控制性超排卵情况、体外受精参数和妊娠结局进行回顾性对照分析.结果 两组的基本情况差异无统计学意义.观察组与对照组的胚胎种植率(26.7% vs 30.5%)、临床妊娠率(48.0% vs 51.0%)、自然流产率(20.8% vs 31.4%)、活产率(32.0% vs 28.0%)、早产率(9.4% vs 7.1%)差异无统计学意义(P>0.05).随访示观察组和对照组的剖宫产率为81.3%(26/32)和71.4%(20/28),差异无统计学意义(P>0.05).观察组剖宫产术中行肌瘤剔除者超过半数(11/20),剔除的肌瘤大小为2~5 cm,无出现术中大出血.结论 不影响宫腔形态的肌壁间子宫肌瘤对IVF-ET临床妊娠结局无明显不良影响.%Objective To evaluate the effect of uterine non-cavity-distorting intramural fibroids on the outcome of IVF.Methods A retrospective study on patients undergoing IVF-ET in the reproductive medicine center was conducted.91 women with intramural fibroids and 100 women free of fibroids were included.All patients underwent sonography to rule out intra-cavity lesions.We compared the basic characteristics and main IVF-ET outcomes between the two groups.Results There was no significant difference between the two groups in basic characteristics.There was no significant difference between study and control groups in implantation rate (26.7% vs.30.5%), clinical pregnancy rate (48.0% vs.51.0%), spontaneous abortion rate (20.8% vs.31.4%), live birth rate (32.0% vs.28.0%), or premature birth rate(9.4% vs.7.1%).The follow-up results demonstrated that patients in the study group had higher cesarean section rate (81.3% vs.71.4%), but with no statistical significance.More than half of the patients with caesarean section underwent cesarean myomectomy.The intramural fibroids were 2 to 5 cm in diameter.No major hemorrhage during cesarean myomectomy was reported.Conclusion Non-cavity-distorting intramural fibroids have no effect on the outcome of IVF.
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