POI患者解冻周期内膜方案妊娠结局比较

The comparison of pregnancy outcomes in different programs of FET in premature ovarian insufficiency patients

目的探讨不同内膜准备方案对早发性卵巢功能不全(Remature Ovarian Insufficiency,POI)患者解冻周期妊娠结局的影响。方法回顾分析解冻胚胎移植的POI患者179例,按照不同的内膜方案分为两组:A组:降调节+人工周期(n=191例),B组:自然周期(n=78例)。分析两组年龄、体重指数(BMI)、基础雌二醇(E2)、基础促卵泡生成素(FSH)、基础促黄体生成素(LH)、抗苗勒管激素(AMH)、抑制素(Inhibin B,INH B)。比较胚胎移植当天子宫内膜厚度,比较生化妊娠率、临床妊娠率、胚胎种植率、流产率、异位妊娠率、活产率、婴儿男/女性别比。结果A、B两组一般资料无统计学差异(P>0.05),子宫内膜厚度A组(9.38±1.54 mm)高于B组(8.84±1.61 mm),且有统计学差异(P<0.05),A组生化妊娠率(52.48%)、临床妊娠率(48.51%)、活产率(30.69%)均高于B组(分别为38.46%、33.33%、17.95%),且具有统计学差异(P<0.05)。结论POI患者行解冻胚胎移植,采用降调节+人工周期准备子宫内膜,能获得更好的妊娠结局。

Objective To explore the pregnant outcome`s comparison in different endometrial preparation programs of the FET in premature ovarian insufficiency patients.Methods A retrospective analysis was performed on 179 POI patients with thawed embryo transfer,divided into two groups according to different endometrial regimens,group A:GnRha+artificial cycle(n=191),group B:nature cycle(n=78).The age,BMI,the basic estradiol level(E2),the basic FSH level,the basic LH level,the AMH level,the INH B level were analyzed in two groups.The endometrial thickness in the day of embryo transplantation,and the biochemical pregnancy rate,the clinical pregnancy rate,the embryo implantation rate,the abortion rate,the ectopic gestation rate,the live birth rate,the sex radio of the baby were compared.Results There were no statistical differences in basic data(P>0.05)between two groups.The endometrial thickness in group A(9.38±1.54 mm)is thicker than group B(8.84±1.61 mm),and there was statistically significant(P<0.05).The biochemical pregnancy rate(52.48%),the clinical pregnancy rate(48.51%)and the live birth rate(30.69%)of group A were higher than group B(38.46%,33.33%,17.95%),all of these data had statistical significance(P<0.05).Conclusion When the patients with POI had FET,using GnRha+artificial cycle preparing the endometrium might have better results in pregnancy outcome.