Comparison of medical abortion and surgical abortion in the management of missed abortion after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer
Objective To compare the efficacy of medical abortion and surgical abortion in the management of missed abortion after in vitro fertilization/intracytoplasmic sperm injection-embryo transfer(IVF/ICSI-ET)and their effects on the pregnancy outcomes of subsequent embryo transfer.Methods Patients with missed abortion after IVF/ICSI-ET with gestation weeks less than 13 weeks,treated in the Reproductive Hospital Affiliated to Shandong University during Jan.2016 and Jan.2017 were selected and divided into medical group(n=134)and surgical group(n=130)according to random number table method.The success rate of abortion,changes of endometrial thickness before and after abor-tion,and the pregnancy outcomes of the first embryo transfer after abortion were observed.Results The success rate of surgiacal abortion was significantly higher than that of medical abortion(99.23%vs.85.35%,P<0.001).The endome-trial thickness before embryo transfer on the human chorionic gonadotropin(HCG)day was higher in the surgical group than in the medical group[(1.01±0.19)cm vs.(1.06±0.20)cm,P=0.040].Furthermore,there was a great difference in endometrial thickness before and after embryo transfer in the surgical group compared to the medical group[(-0.01±0.17)cm vs.(0.06±0.17)cm,P=0.008].There were no significant differences in the pregnancy outcomes following the first embryo transfer after abortion between the two groups.Conclusion For missed abortion after IVF/ICSI within 13 weeks of gestation,the efficacy of surgical abortion is higher than that of medical abortion.However,medicine may be more beneficial to endometrial preservation than surgery.The two treatments have no significant impact on the preg-nancy outcomes following the first embryo transfer.
In vitro fertilizationIntracytoplasmic sperm injectionMedical abortionSurgical abortionPregnancy outcomeEndometrial thickness
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