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目的研究输卵管积水不孕患者IVF-ET中临床超促排卵用药和胚胎质量,探讨输卵管积水导致不孕的病理生理机制和有效的临床诊疗原则。方法回顾性比较分析105例输卵管积水和308例非积水性输卵管因素不孕患者的临床超促排卵用药剂量、用药时间、胚胎质量和临床妊娠结局。结果 1输卵管积水组和非积水组超促排剂量和促排天数没有显著性差异;2积水组2PN受精率、卵裂率、优质胚胎率、早期流产率高于非积水组,妊娠率、种植率低于积水组,均没有显著性差异。积水组异位妊娠率显著低于非积水组(P<0.001)。3双侧输卵管积水组促排起始剂量、促排总量、早期流产率高于单侧积水组,平均获卵数、MII率、2PN率、卵裂率、优质胚胎率、妊娠率、种植率低于单侧输卵管积水组,但没有统计学差异。结论在IVF-ET过程中有必要对输卵管积水进行预处理,或新鲜周期获得胚胎待积水处理后行解冻胚胎移植。
Objective To study the clinical application of ovulation induction and embryo quality in IVF-ET patients with hydronephrosis and explore the pathophysiological mechanisms and effective clinical diagnosis and treatment principles of tubal hydrops. Methods A retrospective analysis of 105 cases of tubal hydrops and 308 cases of non-hydrostatic tubal infertility patients with clinical ovulation dose, medication time, embryo quality and clinical pregnancy outcomes. Results 1 Hydrotubation group and non-hydronephrosis group had no significant difference in the number of superoxide dismutase and promoting the number of days of promoting discharge.2 Hydrops group 2PN fertilization rate, cleavage rate, high-quality embryo rate and early abortion rate were higher than those in non-hydronephrosis group, The pregnancy rate and implantation rate were lower than those in the stagnant water group, and no significant difference was found. The rate of ectopic pregnancy in hydrocephalus group was significantly lower than that in non-hydronephrotic group (P <0.001). 3 bilateral hydrosalpinx group, the initial dose, the total amount of promoting row, early abortion rate was higher than the unilateral hydronephrosis group, the average number of oocytes retrieved, MII rate, 2PN rate, cleavage rate, high quality embryo rate, pregnancy rate , Implantation rate is lower than unilateral tubal hydrops, but no statistical difference. Conclusions In IVF-ET, it is necessary to pre-treat hydrosalpinx or to obtain embryos to be hydropsified to be thawed after fresh embryo transfer.