张潇潇，王渝，吕群（四川省医学科学院/四川省人民医院生殖中心，成都610072）

·论著·

胚胎移植位置对体外受精临床结局的影响

张潇潇，王渝，吕群△
（四川省医学科学院/四川省人民医院生殖中心，成都610072）

目的探讨在腹部超声引导下定位胚胎移植对体外受精（IVF）-胚胎移植妊娠结局的影响。方法回顾性研究2014年1月至2015年1月在四川省人民医院生殖中心行IVF患者406例，按超声下移植胚胎距宫底距离占宫深比例的不同分为五组：A组（≤1/5）共58个周期、B组（＞1/5～2/5）共82个周期、C组（＞2/5～3/5）共104个周期、D组（＞3/5～4/5）共96个周期、E组（＞4/5）共66个周期。比较胚胎移植位置对IVF结局的影响。结果胚胎移植位置占宫深比例在大于1/5～4/5的B、C、D组的临床妊娠率（56.10%、56.73%、55.21%）明显高于A、E组（22.41%、21.21%），差异均有统计学意义（P＜0.05）；而各组异位妊娠率、流产率比较，差异均无统计学意义（P＞0.05）。结论移植胚胎位置距离宫底的位置占宫深的比例在大于1/5～4/5时，会有更高的临床妊娠率。

受精，体外；胚胎移植；妊娠结局；妊娠率

【Abstract】Objective To investigate the influence of positioning embryo transfer on the in vitro fertilization（IVF）-embryo transfer（ET）pregnant out come under the abdominalul trasound guidance.M ethods A totalof406 women under going IVF in the reproducti vemedicine centerofour hospital from January 2014 to January 2015were analyzed retrospectively.All406 cases were divided into five groups according to different proportions of embryo transfer distance from the uterine fundus occupying the uterine depth：the group A（≤1/5）with 58 cycles，B（＞1/5-2/5）with 82 cycles，C（＞2/5-3/5）with 104 cycles，D（＞3/5-4/5）with 96 cycles and E（＞4/5）with 66 cycles.The influence of embryo transfer location on the IVF out come was compared.Results In the proportion of embryo transfer location from the uterine fun dusoccupying the uterine depth＞1/5～4/5，the pregnancy rates in the group B，C and Dwere 56.10%，56.73% and 55.21% respectively，which were significantly higher than 22.41% and 21.21% in the group A and E，the differences were statistically significant（P＜0.05）.But there were no statistically significant differences in theaspects of ectopic pregnancy rateand abortion rateamong the five groups（P＞0.05）.Conclusion The proportion of embryo transfer location from the uterine fun dusoccupying theuterine depth＞1/5-4/5 hashigher clinicalpregnancy rate.

【Key words】Fertilization in vitro；Embryo transfer；Pregnancy out come；Pregnancy rate

随着不孕症发病率的增高，体外受精（IVF）技术的应用日益广泛。经过30多年的发展，IVF妊娠率得到明显提高，尤其当医生开始在胚胎移植中应用腹部超声进行引导以后。在整个IVF周期中，关键的最后一步就是胚胎移植，甚至决定患者助孕技术的成败［1］。很多学者关注于研究如何优化胚胎移植，从而提高临床的妊娠结局，目前，对最佳的胚胎放置宫腔部位，国际上尚无统一观点。本研究回顾性分析406例在四川省人民医院生殖中心进行新鲜周期胚胎移植中胚胎放置位置与妊娠相关结局的关系，以探讨其对新鲜周期胚胎临床结局的影响。……