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目的:探讨输卵管性不孕患者进行体外受精-胚胎移植(IVF-ET)后自然妊娠的可能性以及与发生自然妊娠相关的临床条件。方法:对1999年11月至2007年6月于本院生殖中心因输卵管因素不孕进行IVF的患者进行随访,回顾性分析IVF后发生自然妊娠的13例患者的临床特征、IVF助孕情况和自然妊娠情况。结果:13例输卵管因素不孕患者行IVF治疗时的年龄为31.8±4岁(27-41岁),不孕年限5.2±2.2年(2-8年)。行IVF治疗发生生化妊娠1例,流产1例,单胎足月分娩1例。11例患者在IVF后6月内发生自然妊娠,另2例分别在IVF后2年和8年发生自然妊娠。其中,2例有异位妊娠史的患者发生对侧输卵管妊娠,1例发生流产,7例已生育健康后代,3例正处于中孕期。结论:输卵管因素不孕患者行IVF后仍有可能发生自然妊娠,尤其是年轻(<35岁)患者。IVF失败或放弃IVF治疗后患者心理状态的变化,也可能有助于激发其生育潜能,促成自然妊娠的发生。
Objective: To investigate the possibility of spontaneous pregnancy after IVF-ET and the clinical conditions associated with spontaneous pregnancy in patients with tubal infertility. Methods: From November 1999 to June 2007 in our hospital reproductive center due to tubal infertility IVF were followed up retrospectively analyzed the clinical features of 13 cases of spontaneous pregnancy after IVF, IVF assisted pregnancy and Natural pregnancy situation. Results: The age of 13 cases with tubal infertility who underwent IVF treatment was 31.8 ± 4 years (27-41 years) and the duration of infertility was 5.2 ± 2.2 years (2-8 years). Line IVF treatment occurred in 1 case of biochemical pregnancy, abortion in 1 case, single fetus delivery in 1 case. Eleven patients had a spontaneous pregnancy within 6 months of IVF, and two had a natural pregnancy two and eight years after IVF, respectively. Among them, 2 patients with history of ectopic pregnancy contralateral tubal pregnancy occurred, 1 case of abortion, 7 cases have been healthy offspring, 3 cases are in the second trimester. CONCLUSION: Natural pregnancy is still likely to occur after IVF in patients with tubal infertility, especially in young (<35 years) patients. IVF failure or to give up IVF after treatment of patients with changes in psychological state, may also help stimulate their fertility potential, resulting in the occurrence of natural pregnancy.