摘要
目的 探讨对于胚胎反复种植失败(RIF)患者,宫腔灌注不同物质对冻融胚胎移植(FET)周期妊娠结局的影响。方法 回顾性分析2018年5月至2021年10月于中国人民解放军联勤保障部队第九八○医院生殖中心接受冻融胚胎移植(FET)治疗并行宫腔灌注的120例RIF患者的临床资料。根据宫腔灌注药物不同分为3组:宫腔灌注HCG的HCG组(44例),宫腔灌注粒细胞集落刺激因子(G-CSF)的G-CSF组(42例),宫腔灌注G-CSF+地塞米松磷酸钠注射液(DexSPI)的G-CSF+DexSPI组(34例);选择同期行激素替代周期准备内膜、仅行FET(未行宫腔灌注)的36例患者为对照组。比较各组患者的一般情况、胚胎移植和内膜情况及妊娠结局。结果 4组患者间平均年龄、不孕年限、体质量指数(BMI)、基础卵泡刺激素(bFSH)、基础黄体生成素(bLH)及基础雌二醇(bE_(2))水平比较均无显著性差异(P>0.05)。4组患者间既往移植失败周期数、移植失败周期优胚数、本次移植胚胎数、优胚数、转化日内膜厚度及胚胎移植日内膜厚度比较均无显著性差异(P>0.05)。HCG组、G-CSF组及G-CSF+DexSPI组患者的胚胎着床率、临床妊娠率均显著高于对照组(P<0.05),而3组患者间比较均无显著性差异(P>0.05);4组患者间早期流产率、异位妊娠率比较均无显著性差异(P>0.05)。结论 对于RIF患者,FET前行宫腔灌注HCG、G-CSF或G-CSF+DexSPI,均可以改善子宫内膜容受性,提高患者的胚胎着床率及临床妊娠率。
Objective:To investigate the effect of intrauterine perfusion with different drugs in patients with frozen-thawed embryo transfer(FET)after recurrent implantation failure(RIF).Methods:The clinical data of 120 RIF patients who were received FET treatment and intrauterine perfusion in the 980^(th) Hospital of the PLA Joint Logistics Support Force from May 2018 to October 2021 were retrospectively analyzed.They were divided into three groups according to the different intrauterine perfusion drugs:perfusion with HCG in HCG group(n=44),perfusion with granulocyte colony stimulating factor in G-CSF group(n=42)and perfusion with G-CSF plus dexamethasone in G-CSF+DexSPI group(n=34).The control group consisted of 36 patients who received hormone replacement cycle to prepare endometrium and only received FET(without intrauterine perfusion)at the same time.The general condition,embryo transfer,endometrium condition and pregnancy outcome of each group were compared.Results:There were no significant differences in the average age,infertility years,body mass index(BMI),basal FSH(bFSH),basal LH(bLH)and basal estradiol(bE_(2))among the four groups(P>0.05).There were no significant differences in the number of cycles of previous transplantation failure,the number of excellent embryos in the failed transplantation cycle,the number of embryos transferred,the number of excellent embryos and the endometrial thickness of on the transformation day in this cycle among the four groups(P>0.05).The implantation rate and clinical pregnancy rate of the patients in HCG group,G-CSF group and G-CSF+DexSPI group were significantly higher than those in the control group(P<0.05).The early abortion rate and ectopic pregnancy rate were not significantly different among the four groups(P>0.05).Conclusions:For RIF patients,intrauterine perfusion with HCG,G-CSF or G-CSF+DexSPI before FET can improve endometrial receptivity,and increase embryo implantation rate and clinical pregnancy rate of patients.
作者
程立立
刘少华
刘珊
许鹏宇
李冬秀
刘秀萍
刘松娜
齐丽丽
CHENG Li-li;LIU Shao-hua;LIU Shan;XU Peng-yu;LI Dong-xiu;LIU Xiu-ping;LIU Song-na;QI Li-li(The Third Hospital of Hebei Medical University,Shijiazhuang 050000;The First Affiliated Hospital of Xingtai Medical College,Xingtai 054000;The 980 th Hospital of the PLA Joint Logistics Support Force,Shijiazhuang 050000)
出处
《生殖医学杂志》
CAS
2022年第11期1500-1505,共6页
Journal of Reproductive Medicine
基金
河北省卫健委立项青年科技课题(20210330)。
