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目的:探讨体外受精-胚胎移植术中(in vitro fertilization-embryo transfer,IVF-ET)胚胎移植内管距宫底距离(transfer distance from the fundus,TDF)与临床妊娠的关系。方法:选择常规长方案取卵患者759个周期,胚胎移植时阴道B超测量TDF,依据TDF分A、B、C 3组:即<1 cm组、1～1.5 cm组、>1.5 cm组,比较各组IVF-ET的相关指标及其临床结局。结果:①3组在平均年龄、不孕年限、基础血FSH、体重指数、Gn总量、获卵数、受精数、可利用胚胎数、优胚数、移植胚胎数比较,均无统计学差异(P>0.05);②C组胚胎种植率(33.6%)高于B组(23.5%)(P<0.05);A、B、C 3组间的临床妊娠率比较无统计学差异(P>0.05),但A组最低,C组最高;B组流产率高于C组(P<0.05);各组之间异位妊娠率无统计学差异。结论:在B超引导下进行胚胎移植时,移植内管距宫底>1.5 cm更有助于提高临床妊娠率和胚胎种植率,降低流产率。
Objective: To investigate the relationship between transfer distance from the fundus (TDF) and clinical pregnancy in in vitro fertilization-embryo transfer (IVF-ET) embryo transfer. Methods: 759 cycles of ovulation were selected in the conventional long protocol. TDF was measured by vaginal ultrasonography during embryo transfer. According to TDF, groups A, B and C were divided into 3 groups: <1 cm group, 1 ~ 1.5 cm group and> 1.5 cm group. Relative indicators of IVF-ET in each group and their clinical outcomes were compared. Results: ① There was no significant difference in average age, duration of infertility, basal blood FSH, body mass index, total amount of Gn, number of oocytes retrieved, number of fertilization, number of available embryos, number of excellent embryos and number of embryos transferred (P> 0.05) .②The embryo implantation rate in group C was significantly higher than that in group B (33.6% vs 23.5%, P <0.05). There was no significant difference in clinical pregnancy rates between groups A, B and C (P> 0.05) , But the lowest in group A and the highest in group C. The abortion rate in group B was higher than that in group C (P <0.05). There was no significant difference in ectopic pregnancy between groups. CONCLUSION: When transplanted with B ultrasound guided embryo transfer, the intrauterine graft is more than 1.5 cm from the fundus of the uterus, which is more helpful to improve the clinical pregnancy rate and embryo implantation rate and reduce the abortion rate.