研究開発・学会発表

【Objective】Hysteroscopy is one of routine examination to evaluate a uterine cavity for infertility work up. It has been described in many studies that an endometrial polyp affects adversely to the implantation of embryos to endometria. The fallopian tubal ostia, however, has not been evaluated with regard to clinical outcome in ART. We investigate that implantation rate(IR) and pregnancy rate(PR) in early cleavage stage embryo transfer(ECT) and blastocyst transfer (BT) according to the finding of tubal ostia.

【Materials and methods】We evaluated 373 infertility patients who underwent ART for the first time and frozen thawed single embryo transfer between July 2011 and January 2012. Their uterine cavities were examined before embryo transfer by hysteroscope. Stenosis, obstraction and adhesion of the ostia are defined as abnormal findings. 70 embryos were transferred at early cleavage stage and 120 embryos were transferred at blastocyst stage in this study. 【Results】Abnormal tubal ostia was found in 69/240(28.8%) of the cases. IR with normal ostia was higher than that with abnormal ostia : 18/45(40%) and (5/25(20%)), respectively. PR with normal ostia was also higher than that with abnormal ostia : 10/45(22.2%) and 3/25(12%), respectively in ECT. However the difference is not significant. In BT, IR with normal ostia was 55/94(58.5%) and that with abnormal ostia was 44/76(57.9%). PR was 27/76(35.5%) and 27/94 (28.7%), respectively. Patients who had with both abnormal ostia and seropositive Chlamydia antibodies were 2 out of 70 (2.9%).

【Conclusion】Ostia evaluation may be important for the prediction for ECT outcome. However in BT, finding of the ostia were not associated with the IR and PR. Chlamydia infection may not be the main cause the abnormal ostia.