摘要
目的探讨多次胚胎种植失败的患者行降调节联合激素替代周期方案对冻融胚胎移植妊娠结局的影响。方法回顾性分析2013年12月至2014年12月在首都医科大学附属北京妇产医院生殖中心接受冻融胚胎移植且既往胚胎种植失败次数≥2次的患者共174例。根据本次冷冻移植周期子宫内膜准备方法分为2组:其中A组采用促性腺激素释放激素-激动剂(gonadotrophin-releasing hormone agonist,GnRHa)降调节联合激素替代周期(hormone replacement therapy,HRT)方案(n=78),B组采用单纯激素替代周期方案(n=96),分析2种内膜准备方案对患者妊娠结局的影响。结果 2组患者的不孕年限、年龄、体质量指数、基础内分泌激素浓度;移植胚胎数、优质胚胎数、胚胎复苏率、黄体酮转化日子宫内膜厚度;胚胎种植率(22.8%vs19.8%)、临床妊娠率(42.3%vs 37.5%)、早期流产率(9.1%vs 11.1%)比较,差异均无统计学意义(P>0.05)。结论对多次胚胎种植失败的患者,GnRHa降调节联合激素替代方案在胚胎着床率和临床妊娠率方面较单纯激素替代周期方案有升高趋势,但差异无统计学意义(P>0.05),有待于进一步扩大样本量研究。
Objective To investigate the clinical value of a gonadotropin-releasing hormone agonist（GnRHa） suppression protocol on multiple implantation failed patients undergoing frozen-embryo transfer （FET） cycles. Methods A total of 174 women undergoing FET cycles with a history of multiple implantation failure in our center from December, 2013 to December, 2014 were retrospectively analyzed. Patients were divided into two groups： 78 women in group A experienced a GnRHa suppression protocol, and 96 women in group B experienced a normal hormone replacement therapy （HRT）. The clinical outcomes were compared between the two groups. Results Patients in the two groups had similar baseline characteristics, including duration of infertility, age, body mass index and basal endocrine level. There were no significant differences between the two groups in the number of transferred and high-quality embryos, the survival rate of frozen embryos, endometrial thickness, the implantation rate （22.8% vs 19.8% ）, clinical pregnancy rate （42.3 % vs 37.5% ）, and early miscarriage rate（9.1% vs 11.1% ）. Conclusion This study found that the implantation rate and clinical pregnancy rate in the GnRHa suppression group experienced a tendency to increase in the patients with a history of multiple implantation failure, compared to the normal HRT group, but the difference was not statistically significant. A larger sample size may be needed for the further study.
出处
《首都医科大学学报》
CAS
北大核心
2015年第4期544-547,共4页
Journal of Capital Medical University
基金
国家自然科学基金项目(81170542
81471431)
北京市自然科学基金项目(7152055)
首都医科大学附属北京妇产医院学科带头人项目(2013-2)~~
关键词
冻融胚胎移植
多次胚胎种植失败
促性腺激素释放激素-激动剂
激素替代周期
frozen-thawed embryo transfer（FET）
multiple implantation failure
gonadotropin-releasing hormone agonists（GnRHa）
hormone replacement therapy （HRT）
