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目的 对行胚胎植入前遗传学检测（PGT）助孕的患者，比较宫腔镜检查及处理对遗传学检测胚胎移植结局的影响。方法 回顾性分析行体外受精（IVF）助孕的261个移植周期和PGT助孕的267个移植周期，其中IVF助孕移植周期分为胎移植前行宫腔镜检查组（IVF-H组）共134个周期，胚胎移植前未行宫腔镜检查组（IVF-N组）共127个周期；PGT助孕移植周期分为胚胎移植前行宫腔镜检查组（PGT-H组）有140个周期，胚胎移植前未行宫腔镜检查组（PGT-N组）共127个周期，分别分析比较IVF-H、IVF-N两组及PGT-H、PGT-N两组的一般情况及妊娠结局。结果IVF-H、IVF-N两组间及PGT-H、PGT-N两组间年龄、BMI及基础激素水平差异无统计学意义，IVF-H组的生化妊娠率、临床妊娠率及活产率略高于IVF-N组（P>0.05），早期流产率小于IVF-N组（P>0.05），但差异均无统计学意义。PGT-H组的生化妊娠率及临床妊娠率均高于PGT-N组（P<0.05）。PGT-H组及PGT-N组的早期流产率近似（P>0.05）。PGT-H组的活产率高于PGT-N组，但差异无统计学意义(P>0.05)。结论 宫腔镜检查可提高临床妊娠率、活产率，PGT助孕患者妊娠改善幅度优于IVF助孕人群。
Abstract：Objective To evaluate the impact of hysteroscopic examination and subsequent management on reproductive outcomes in embryo transfer cycles among patients undergoing preimplantation genetic testing (PGT). Methods This retrospective analysis included 261 transfer cycles from in vitro fertilization (IVF) and 267 transfer cycles from PGT. Among IVF cycles， 134 underwent hysteroscopy prior to embryo transfer (IVF-H group)， while 127 did not (IVF-N group). Among PGT cycles， 140 received hysteroscopy before transfer (PGT-H group)， and 127 did not (PGT-N group). We compared general characteristics and pregnancy outcomes between the IVF-H and IVF-N groups， as well as between the PGT-H and PGT-N groups. Results No significant differences were observed in maternal age， body mass index， or baseline hormone profiles between the IVF-H and IVF-N groups， nor between the PGT-H and PGT-N groups. The IVF-H group showed higher rates of biochemical pregnancy， clinical pregnancy， and live birth， along with a lower early miscarriage rate， compared with the IVF-N group. However， these differences did not reach statistical significance (all P>0.05). In the PGT cohort， the PGT-H group had significantly higher biochemical and clinical pregnancy rates than the PGT-N group (P<0.05). Early miscarriage rates were comparable between the PGT-H and PGT-N groups (P>0.05). Although the live birth rate was higher in the PGT-H group than in the PGT-N group， the difference was not statistically significant (P>0.05). Conclusion Hysteroscopic evaluation before embryo transfer may be associated with improved clinical pregnancy and live birth rates. This benefit appears more pronounced in patients undergoing PGT compared with those receiving conventional IVF treatment.
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基本信息:
中图分类号:R714.8
引用信息:
[1]夏金铃,郝燕,陈大蔚,等.宫腔镜检查对遗传学检测胚胎移植结局的影响[J].安徽医科大学学报().
基金信息:
国家自然科学基金项目（编号:U24A20764、82001631）; 合肥综合性国家科学中心大健康研究院健康大数据与群体医学研究所项目（编号：JKS2022012）
2026-07-21
2026-07-21
2026-07-21