4种子宫内膜准备方案在冻融胚胎移植中的应用价值

The clinical value of four methods of endometrium preparation for frozen-thawed embryo transfer cycle

目的探讨4种不同子宫内膜准备方案在冻融胚胎移植(FET)中的应用价值。方法回顾性分析2013年3月至2015年3月在清远市人民医院生殖医学中心进行的320个FET周期,其中自然周期组(A组)70周期,促排卵组(B组)152周期,激素替代组(C组)74周期,降调后激素替代组(D组)24周期,比较4组FET的治疗结局。结果 B、C、D组的临床妊娠率和胚胎种植率均显著高于A组(P<0.05);4组的多胎妊娠率、生化妊娠率、早期妊娠流产率和异位妊娠率等指标间的差异均无统计学意义(P>0.05);D组FET周期次数显著高于其他3组(P<0.05)。结论在FET中,促排卵、激素替代和降调后激素替代方案均可获得良好的治疗结局,降调后激素替代方案在既往移植失败患者中具有较好疗效。

Objective To estimate the clinical value of 4 methods of endometrium preparation for frozen-thawed embryo transfer（FET）cycle.Methods Total 320 FET cycles completed in center of reproductive medicine of Qingyuan people′s hospital from March 2013 to March 2015 were retrospectively analyzed,and divided into 4groups：natural cycle group（group A,n=70）,ovulation-inducing cycle group（group B,n=152）,hormone replacement treatment（HRT）cycle group（group C,n=74）,down-regulated HRT cycle（group D,n=24）.The pregnancy outcomes were followed and compared among these different 4groups.ResultsIn FET cycles,the clinical pregnancy rates and implantation rates of group B,group C and group D were significantly higher than that of group A（P〈0.05）,there were no significant differences in the rates of multiple pregnancy,biochemical pregnancy,early abortion and ectopic pregnancy among 4groups（P〈0.05）.However,the rank of the FET cycle of group D was significantly higher than those of the other three groups（P〈0.05）.Conclusion In FET cycles,the methods of ovulation-inducing,HRT and down-regulated HRT all have favorable clinical outcomes,and the method of down-regulated HRT is more suitable for patients with previous implantation failure.