生长激素在IVF-ET周期子宫内膜发育不良患者中的应用

Growth Hormone(GH) Co-treatment for Patients with the Maldevelopment of Endometrium Undergoing IVF-ET

目的:探讨生长激素(growth hormone,GH)在体外受精-胚胎移植(in vitro fertilization-em-bryo transfer,IVF-ET)治疗中对子宫内膜发育不良者子宫内膜及临床结局的影响。方法:IVF-ET患者共67例,均由于子宫内膜发育不良而致IVF-ET种植失败,再次行IVF-ET治疗时随机分为研究组(加用GH治疗,32例)和对照组(未使用GH治疗,35例),统计分析患者的临床结局。结果:患者Gn用量、平均获卵数、受精率、优质胚胎率组间无统计学差异(P>0.05);研究组子宫内膜厚度、形态及子宫内膜和内膜下血流均较对照组有明显改善(P<0.01);研究组的胚胎种植率(31.4%)及临床妊娠率(39.5%)明显高于对照组(15.7%和19.8%)(P<0.01),早期流产率明显减低(14.6%vs 21.4%)(P<0.01)。结论:对内膜发育不良的患者进行IVF-ET治疗时加用GH可能是通过改善子宫内膜对胚胎的容受性,从而提高胚胎种植率及临床妊娠率,降低早期流产率。

Objective： To evaluate the efficacy of growth hormone（GH） co-treatment for patients with the maldevelopment of endometrium undergoing in vitro fertilization-embryo transfer（IVF-ET）.Methods： The clinical data of 67 patients who were failed in previous IVF-ET treatment as a result of maldevelopment of endometrium were analyzed.In the second cycle,the 67 patients were randomly divided into two groups,the study group consisting of 32 cases with using GH and the control group consisting of 35 cases without using GH.Results： After using GH,there were no statistical differences between the two groups on the dose of Gn used,the number of oocytes retrieved,the rate of fertilization and good embryos（P0.05）.The endometrial thickness,endometrial pattern,endometrial and subendometrial blood flows on the day of hCG administration in the study group were improved than that of the control（P0.01）.Embryo implantion rate and clinical pregnancy rate in the study group were significantly improved while early spontaneous abortion rate delated than those of the control（P0.01）.Conclusion： For patients with the maldevelopment of endometrium undergoing IVF-ET,growth hormone（GH） supplementation can improve embryo implantion rate,clinical pregnancy rate,and reduce early spontaneous abortion rate perhaps through affecting the endometrial receptivity.