摘要
目的 研究不同内膜准备方案对子宫内膜异位症(EMs)患者囊胚冻融移植(FET)妊娠结局的影响。方法 回顾性分析EMs患者375个囊胚FET周期,按照子宫内膜准备方式分为:单纯人工周期组(HRT组,45个周期),促性腺激素释放激素激动剂降调节后人工周期组(GnRH-a+HRT组,121个周期)和自然周期组(NC组,209个周期)。比较3种内膜准备方案的囊胚FET妊娠结局。结果 3组EMs患者间年龄、不孕年限、基础抗苗勒管激素(AMH)和基础内分泌水平比较均无统计学差异(P>0.05)。3组间移植胚胎数比较均无统计学差异(P>0.05)。移植日内膜厚度GnRH-a+HRT组显著厚于HRT组[(10.08±1.79)mmvs.(9.33±1.41)mm,P<0.05]。HRT组胚胎种植率和临床妊娠率(分别为71.43%和75.56%)均显著高于GnRH-a+HRT组(分别为46.63%和57.02%)和NC组(分别为44.13%和54.55%)(P<0.05)。3组患者间多胎率、异位妊娠率比较均无统计学差异(P>0.05)。HRT组流产率(2.94%)显著低于GnRH-a+HRT组(18.84%)和NC组(9.65%)(P<0.05),且GnRH-a+HRT组流产率显著高于NC组(P<0.05)。结论 传统激素替代内膜准备方案可提高EMs患者囊胚FET周期种植率和临床妊娠率,降低流产率,可作为EMs患者高效、经济的FET内膜准备方案。
Objective : To study the effects of different endometrial preparations on the pregnancy outcome of frozen-thawed embryo transfer(FET) in patients with endometriosis(EMs). Methods : A retrospective analysis was performed on 375 FET cycles in patients with EMs. The cycles were categorized into simple artificial cycle group(hormone replacement therapy group,HRT group, n =45),GnRH agonist down-regulation artificial cycle group(GnRH-a+HRT, n =121) and natural cycle group(NC group, n =209) according to the endometrial preparation method. The pregnancy outcome was compared among the three different endometrial preparations. Results : There were no significant differences in age,infertility years,basal AMH,basal hormone level and number of embryos transferred among the three groups( P >0.05). The endometrial thickness of the GnRH-a+HRT group was significantly thicker than that of the HRT group [(10.08±1.79) vs.(9.33±1.41) mm, P <0.05]. The embryo implantation rate and clinical pregnancy rate(71.43% and 75.56%,respectively) in the HRT group were significantly higher than those in GnRH-a+HRT group(46.63% and 57.02%,respectively) and the NC group(44.13% and 54.55%,respectively)( P <0.05). There was no significant difference in the multiple birth rate and ectopic pregnancy rate among the three groups( P >0.05). The abortion rate(2.94%) in the HRT group was significantly lower than that in the GnRH-a+HRT group(18.84%) and the NC group(9.65%)( P <0.05),and the abortion rate in the GnRH-a+HRT group was significantly higher than that of the NC group( P <0.05). Conclusions : The traditional HRT endometrial preparation can improve the implantation rate and clinical pregnancy rate in EMs patients undergoing FET and reduce the abortion rate,which is an efficient and economical FET endometrial preparation for EMs patients.
作者
张群芳
陈国勇
刘芸
ZHANG Qun-fang;CHEN Guo-yong;LIU Yun(Reproductive Medicine Center,Department of Obstetrics & Gynecology,the 900 th Hospital of the Joint Logistics Support Force,PLA,Fuzhou 350001;Fuzhou General Clinic Medical College, Fujian Medical University,Fuzhou 350001;Teaching Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou 350001;Dongfang Hospital Affiliated to Xiamen University,Fuzhou 350001)
出处
《生殖医学杂志》
CAS
2019年第6期619-623,共5页
Journal of Reproductive Medicine
基金
福建省自然科学基金项目(2016J01578)
关键词
子宫内膜异位症
冻融胚胎移植
内膜准备
妊娠结局
Endometriosis
Frozen-thawed embryo transfer(FET)
Endometrial preparation
Pregnancy outcome
