| Objectives Through the follow-up study to investigate the influence of abnormal uterine morphology to the pregnancy outcome of patients who obtain the clinical pregnancy after IVF/ICSI fresh embryo transfer, and provide the pre-delivery for clinical patients with abnormal uterine and health guidance.Methods Do a follow-up study of patients accept IVF/ICSI-ET fresh embryo teansfer and be clinical pregnancy during January 2014-October 2015 in reproductive genetic department of Maternal and Child Health Hospital of Tangshan, follow-up time 22 months. According to the results of pelvic ultrasonography, hysterosalpingogram and hysteroscopy, selected cases be divided into normal uterine group(as the control group, a toal of 427 patients) and abnormal uterine morphology group(as the case group, 63 patients with hysteromyoma, 45 patients with adenomyosis, 19 patients with malformation, a toal of 427 patients), pregnancy outcomes were followed. Compare basic factors, relevant cycle index and the obstetric outcome of pregnancy between the case group and control group. Using SPSS17.0 statistical software for data analysis, normality test measurement data, measurement data to x ±s, using independent sample t test to analyse differences between two groups; Enumeration data to rate(%), using Chi-square test to compare rate of group. When P≤0.05, difference was statistically significant.Results 1 The comparison of two groups of patients generally: The case group has 127 cases, among 85 cases of secondary infertility and 42 cases of primary infertility; The control group has 427 cases, among 220 cases of secondary infertility and 207 cases of primary infertility. The secondary infertility rate of case group was higher significantly than control group(P<0.05); There was no statistically significant differences in age, BMI, duration of infertility, or cycle number of IVF/ICSI-ET(P>0.05). 2 The comparison of two groups of relevant cycle index: The comparison of the total of Gn: The case group’s was 2838.19±1042.31 IU, the control group’s was 2319.62±943.36 IU, the total of Gn of the case group was higher significantly than control group(P<0.05); The comparison of two groups of endometrial thickness at different time: There was no statistically significant differences in endometrial thickness of the second day menstruation, endometrial thickness of HCG day, endometrial thickness of embryo transfer day(P>0.05); The comparison of two groups of endometrial morphology at different time: There was no statistically significant differences in endometrial morphology of HCG day, endometrial morphology of ET day(P>0.05); There was no statistically significant differences in days of Gn, numbers of retrieved oocytes, fertility rate, cleavage rate, high-qualityembryonic rate, graftage embryonic number and implantation rate(P>0.05). 3 The comparison of two groups of pregnancy outcome: The comparison of abortion: The case group has 127 cases, the abortion rate 20.47%, comparison of 2 groups, the case group’s abortion rate was significantly higher than the control group(11.71%)(P<0.05); The case group has 127 cases, the early abortion rate 12.60%, comparison of 2 groups, the case group’s early abortion rate was significantly higher than the control group(6.79%)(P<0.05); There was no statistically significant differences in late abortion rate(7.9% vs 4.9%)( P>0.05); The comparison of abortion between the case subgroups and the control group: The adenomyosis group totally has 45 cases of patient, the abortion rate 33.33%, was significantly higher than the control group(11.71%)(P<0.05); The adenomyosis group totally has 45 cases of patient, the early abortion rate 26.67%, was significantly higher thanthe control group(6.79%)(P<0.05); The hysteromyoma group’s and the malformation group’s abortion rate and early abortion rate compared with the control group respectively, there was no statistically significant differences in abortion rate or early abortion rate(P>0.05); The comparison of premature birth rate: The case group has 127 cases, preterm birth rate 19.69%, the control group has 427 cases, preterm birth rate 19.91%, comparison of 2 groups, there was no statistically significant differences in premature birth rate(P>0.05); The comparison of cesarean section rate: The case group 101 gain baby, cesarean section rate 84.16%, the control group 377 gain baby, cesarean section rate 74.01%, comparison of 2 groups, the case group’s cesarean section rate was higher than the control group(P<0.05); The comparison of multiple pregnancy rate: The case group 101 gain baby, multiple pregnancy rste 19.80%, the control group 377 gain baby, multiple pregnancy rate 28.90%, comparison of 2 groups, the case group’s multiple pregnancy rate was higher than the control group’s, but there was no statistically significant differences between the two groups(P>0.05). 4 The comparison of two groups of the neonates: The case group 121 neonates, low weight neonatal rate 19.01%, the control group 486 neonates, low weight neonatal rate 23.05%, comparison of 2 groups, there was no statistically significant differences in low weight neonatal rate(P>0.05); The case group 121 neonates, birth defects rate 1.65%, the control group 486 neonates, birth defects rate 1.03%, comparison of 2 groups, there was no statistically significant differences in birth defects rate(P>0.05).Conclusions 1 The abortion rate of patients with abnormal uterine is higher than patients with normal uterine after IVF/ICSI fresh embryo, mainly for early abortion rate increases. 2 Among patients with abnormal uterine, the abortion rate and early abortion rate of patients with uterine adenomyosis is higher than patients with normal uterine. 3 The cesarean section rate of patients with abnormal uterine is higher than patients with normal uterine. |
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