阿托西班及益肾安胎汤对反复种植失败患者治疗的临床结局分析

Effects of different medication measures on pregnancy outcome of RIF women with high-frequency endometrial peristalsis undergoing frozen embryo transfer

目的探讨阿托西班针联合益肾安胎汤剂对反复种植失败合并高频率子宫内膜蠕动波的患者再次冻融胚胎移植周期临床结局的影响.方法回顾性分析2018年5月至2019年5月再次冻融胚胎移植的反复种植失败患者的临床资料,纳入将冻融胚胎移植术前3h子宫内膜蠕动波频率≥3次/min的患者,分别给予不同治疗,阿托西班针注射(A组,40例)、益肾安胎汤剂口服(B组,30例)、阿托西班针+益肾安胎汤剂(C组,35例);比较各组胚胎着床率、生化妊娠率、临床妊娠率、异位妊娠率、早期流产率及继续妊娠率.结果三组患者较既往种植失败周期妊娠结局有明显改善,尤其C组较A组、B组胚胎种植率(36.67%vs.28.57%vs.31.11%)、临床妊娠率(37.14%vs.33.50%vs.30.00%)、继续妊娠率(34.29%vs.27.50%vs.26.67%)有增加趋势,但差异无统计学意义(P>0.05).B、C组均无异位妊娠发生.结论反复种植失败合并子宫内膜高频率蠕动波患者,经阿托西班针注射、益肾安胎汤剂口服后,三组患者临床结局均能得到改善,尤其中西医结合用药能为反复种植失败患者再次冻融胚胎移植带来更多的有利影响.

Objective To analyze the effect of Atosiban therapy and YiShenAnTai decoction to recurrent implantation failure(RIF)patients with high-frequency endometrial peristalsis during frozen-thawed embryo transfer(FET).Methods A retrospective analysis was performed in 105 RIF women with high-frequency endometrial peristalsis.The clinical data were analyzed.Patients were divided into three groups.Patients in group A(n=40)received Atosiban 0.5h before and lh after embryo-transfer operation;Patients in group B(n=30)received YiShenAnTai decoction,14 days after operation.Patients in group C(n=35)received Atosiban therapy and YiShenAnTai decoction together.Pregnancy outcome of FET was valued,including embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate,early abortion rate,ectopic pregnancy rate and ongoing pregnancy rate.Results Three groups patients all got a ideal pregnancy results compared with themselves before.Patients in group C achieved better outcomes than group A and B,especially the embryo implantation rate(36.67%vs.28.57%vs.31.11%),the clinical pregnancy rate(37.14%vs.33.50%vs.30.00%)and the ongoing pregnancy rate(34.29%vs.27.50%vs.26.67%).Howere,there weren*t statistically significant differences detected in all the pregnancy outcome indicators between the three groups(P>0.05).Conclusions A ideal pregnancy outcomes o f FET can be obtained by the treatment o f Atosiban therapy or YiShenAnTai decoction in RIF women with high-frequency endometrial peristalsis,especially integrated Chinese Herbs and Western Medicine can get a even better result.