子宫内膜刺激在体外受精-胚胎移植提高活产率的探讨

Influence of local mechanical injury to the endometrium in the the clinical pregnancies and live births in assisted reproductive technology

目的探讨子宫内膜机械刺激改善子宫内膜容受性对临床妊娠率、胚胎着床率和活产率的影响。方法对进入周期患者在月经3-5天采用一次性宫腔组织吸引管进行宫内膜刺激,刺激宫内膜476个移植周期,对照组未刺激为471个移植周期。结果内膜刺激组移植胚胎数1238个,共着床193个,着床率为15.6%,临床妊娠率为32.6%(155/476),活产率达62.6%(97/155);对照组移植胚胎数1191个,着床166个,着床率为13.9%,临床妊娠率为30.8%(145/471),活产率为49.0%。内膜刺激组与对照组在胚胎着床率和临床妊娠率之间无显著差异(P>0.05),但有升高的趋势;而内膜刺激显著提高了活产率(P<0.05)。结论机械刺激子宫内膜对IVF-ET周期胚胎着床率和临床妊娠率有所提高,能显著提高活产率。

Objective：To explore the posssibility that the local mechanical injury to the endometrium may increase the incidence of embryo implantation,clinical pregnancy and live births in assisted reproductive technology.Methods： The patients undergoing 476 embryo transfer （ET） cycle were conducted local mechanical injury to the endometrium with one-off suction tubes for uterine cavity on day 3-5 of menstrual cycle.471 ET-cycle patients were not treated as control.The rates of embryo implantation,clinical pregnancy and live births in the two groups were compared.Results： There were no significant differences between the trial and control group in the rates of embryo implantation （15.6% VS 13.9%）,clinical pregnancy （32.6% VS 30.8%）,but the local mechanical injury to the endometrium seem to have a tendency to increase these two virables.As a result,The live birth rate was significantly improved by the mechanical injury to the endometrium （62.6% VS 49.0%）.Conclusion：The local mechanical injury to the endometrium may have a tendency to increase the rates of embryo implantation and clinical pregnancy and could significantly improve the chances for live birth rate in patients undergoing IVF-ET.