黄晓燕医生的科普号

今年是我医生生涯中第一例试管婴儿诞生18周年，在此特别纪念曾经一起苦过乐过的同事们，曾经一起哭过笑过的姐妹们，更祝愿所有的宝宝们聪明、可爱、健康、快乐！各位正在奋斗的姐妹们，加油啦！

生殖医学杂志2007 年10 月第16 卷第5 期黄晓燕等(上海交通大学医学院附属瑞金医院生殖医学中心，上海 200025)【摘要】 目的 探讨超声显示子宫内膜形态不良的不育患者经干预性治疗后行体外受精-胚胎移植( IVF-ET) 的临床效果。方法 采用前瞻性随机对照研究,选取拟行IVF2ET 而于自然周期的卵泡晚期超声提示子宫内膜形态不良的不育患者60 例,随机行宫腔镜辅助下刮宫术( HADC 组) 和常规单纯性刮宫术(DC 组) ,分别观察其治疗前后子宫内膜形态的改变及其与临床妊娠结局的关系。 结果 HADC 组与DC 组A 型子宫内膜的比例治疗后较治疗前明显提高,而B 型、C 型子宫内膜比例明显减少,均具有统计学意义( P < 0. 05) 。但该两组A 型子宫内膜的比例仍明显低于对照组,B 型子宫内膜所占比例明显高于对照组,亦具有统计学意义( P < 0. 05) 。HADC 组的临床妊娠率为56. 7 % ,明显高于对照组的40. 0 %和DC 组的43. 3 % ,差异具有统计学意义( P < 0. 05) ,而后两组比较无显著性差异。 结论 对于超声提示子宫内膜形态不良的患者,有必要选择合适的措施加以干预处理,以有效地提高IVF2ET 的治疗效果。【关键词】 子宫内膜; 控制性卵巢刺激; 宫腔镜; 超声检查

昨天有两位同胞在第一周期的卵泡监测指导同房后成功有喜！HCG分别为6625和892。 上周五的一位排卵日子宫内膜5.5cm，在排卵后20天经超声检查已见宫内非常强壮的妊娠囊。 意想不到的收获！

今天看到JJ宝宝的胎心搏动啦！ 那个有过人流，继发粘连，第一次宫腔镜手术导致子宫穿孔，更严重的粘连，第二次宫腔镜行粘连分离放环，而后早早孕自然流产，子宫内膜最大厚度小于6mm的子宫，在我2个月的治疗后成功妊娠，今天超声下看到宝宝的小小心跳啦！ 这是我们生殖中心里第一个成功有喜的准妈妈，我们今天的每一个工作人员分享了宝宝的巧克力，谢谢！

从下周开始我中心的子宫输卵管造影将全部采用超声下完成，该种新技术依赖于一款专用的超声机器，避免了X线的辐射，并将产生四维图像，可以更全面更客观地显示子宫、输卵管以及盆腔的位置和状态。

Effects of hysteroscopic assisted diagnostic endometrial curettage in controlled ovarian hyperstimulation cyclesAuthors: X. Huang, Y. Shanghai/CN1. Purpose To evaluate the effects of hysteroscopic assisted diagnostic endometrial curettage in patients with abnormal endometrial echoes by transvaginal sonography and to identify its vaule and clinic outcome in the following controlled ovarian hyperstimulation cycles.2. Methods and Materials Eighty patients with an abnormal endometrial echoes and 58 cases with normal endometrial echoes bytransvaginal sonography in follicular phase in natural cycle before the IVF-ET cycle were divided into threegroups; 40 patients with an abnormal endometrial echoes underwent hysteroscopic assisted diagnosticendometrial curettage as HADC group, half of another 40 patients underwent diagnostic endometrial curettageonly as DC group. IVF-ET cycle was performed in the following menstrual cycle. 58 cases with normalendometrial echoes had not undergone any surgery as control group. The pattern of endometrial echoes bytransvaginal sonography was compared before and after surgery in the different cycles in HADC group and inDC group, the clinical characters and outcomes were also compared among three groups. Statistical analysiswas performed using T and 2 test at 0.05 significance level for comparisons between groups.3. Results There was no significant difference in mean age, baseline FSH, peak E2, oocyte retrieved, embryos transferred, and the thickness of endometrium between three groups. In HADC group and in DC group, the ratio of type A endometrial echoes was significantly increased in the following controlled ovarian hyperstimulation cycles (70.0% vs 63.3%) than in previous nature cycles (16.0% vs 20.0%), and the ratio of type B, type C echoes was significantly decreased (P<0.05). But compared with control group, the ratio of type A endometrial echoes was significantly lower both in HADC group and in DC group, and the ratio of type B, type C echoes was significantly higher (P<0.05). The clinic pregnancy rate in HADC group (57.5%) was statistically higher than that of in DC group (42.5%) and in control group (43.1%)(P<0.05). There was no significance difference between DC group and control group (P>0.05).4. Conclusion It is conceivable that hysteroscopic assisted diagnostic endometrial curettage as an effective strategy more likely altered endometrial environment can improve intrauterine disorder and the capacity of reproduction. Patients with an abnormal endometrial echoes by transvaginal sonography underwent diagnostic endometrial curettage, hysteroscopic assisted diagnostic endometrial curettage especially, are highly valuable and significantly increase the clinic pregnancy rate in the following treatment.

The Journal of International Medical Research 2010; 38: 2070 – 2076Modified Natural Cycle for In Vitro Fertilization and Embryo Transfer in Normal Ovarian RespondersHY LOUAND XY HUANGDepartment of Obstetrics and Gynaecology, Ruijin Hospital, School of Medicine, Shanghai JiaoTong University, Shanghai, ChinaControlled ovarian hyperstimulation (COH) using a gonadotrophin-releasing hormone (GnRH) analogue plusgonadotrophins is used widely in in vitro fertilization (IVF), but there can be significant complications. Sixty women with a normal ovarian response participated in a comparison of COH (triptorelin [GnRH agonist] 0.1 mg/day SC from day 21 of the menstrual cycle [before the IVF cycle] and recombinant folliclestimulatinghormone (FSH) 150 – 300 IU/day from day 2 of the IVF cycle, when triptorelin was reduced to 0.05 mg/day) with a modified natural cycle (MNC) treatment (human menopausal gonado trophin [HMG] 150 IU/day IM if serum oestradiol was ≤ 50 pg/ml on day 2 or 3 of the menstrual cycle). The groups did not differ significantly in implantation rate (21.1% and 22.6%, respectively) and clinical pregnancy rate (30.0% and 30.0%, espectively). When comparing successful pregnancies, MNC patients had significantly lower values than COHpatients for total amount of gonadotrophin (HMG and recombinant FSH) used, number of oocytes retrieved and medication cost. It is concluded that MNC seems to be a feasible treatment option, with low medication cost, relatively low risk of complications and, possibly, greater patient acceptability. KEY WORDS: OVARIAN STIMULATION; GONADOTROPHINS; IN VITRO FERTILIZATION; NATURAL CYCLE;

经过一年多辛苦的筹备，曙光医院生殖中心已接受各位不孕不育夫妇的门诊和咨询了，希望我们极具人性化的环境能带给您不一样的心情哦！并能带给每一位患友好孕成真！