3种子宫内膜准备方案对冻融胚胎移植的临床结局比较

Comparison of pregnancy outcome of three endometrial preparation protocols for frozen-thawed embryo transfer

目的通过分析3种子宫内膜准备方案的冻融胚胎移植临床结局情况,探讨如何选择恰当的冻融胚胎移植子宫内膜准备方案。方法对该中心243例冻融胚胎移植周期进行回顾性分析。结果自然周期、激素替代周期和HMG促排卵周期三组冻融胚胎移植患者的年龄、不孕年限、胚胎完整率和优胚率比较,差异均无显著性(P>0.05);3组子宫内膜厚度及其A型内膜百分率比较,差异具有显著性(P<0.05);3组种植率及妊娠率比较,差异无显著性(P>0.05)。结论 3种子宫内膜准备方案各有优缺点,自然周期是冻融胚胎子宫内膜准备最经济有效的首选方案;对于排卵障碍或子宫内膜薄者,激素替代周期及HMG促排卵周期不失为内膜准备的补充措施。临床医生应因人而异选择适宜的子宫内膜准备方案。

【Objective】 To analyze the pregnancy outcome of three protocols of endometrial preparation for frozen-thawed embryo transfer to select the optimal endometrial preparation method for frozen-thawed embryos transfer.【Methods】 A retrospective analysis of 243 frozen-thawed embryos transfer cycles for our reproductive center.【Result】 There was little difference between the different clinical protocols,such as natural cycle,hormone replacement treatment cycle（HRT）,hMG cycle,in age of the woman,time of infertility,rate of intact embryos and high-quality embryos;There was significant difference in endometrial thickness and type A of these（P 0.05）.The three groups differed little in the implantation rate and clinical pregnancy rate（P 0.05）.【Conclusion】 The three protocols in endometrial preparation have both merit and demerit,the natural cycle is a first choice of cost-effective in endometrial preparation for frozen-thawed embryo transfer;HRT and hMG cycle are additional measures in endometrial preparation for ovulation failure or lepthymenia.A specific protocol should be made according to the individual conditions of the patient.