子宫内膜轻创术对拮抗剂方案体外受精治疗结局的改善

Effect of endometrial surgery with minimal damage on the outcome of in vitro fertilization with GnRH antagonists

目的:探讨子宫内膜轻创术对拮抗剂方案体外受精-胚胎移植临床妊娠率、胚胎种植率和活产率的影响。方法:回顾性分析2007年1月～2009年12月在该院生殖中心行拮抗剂方案体外受精-胚胎移植(IVF-ET)治疗的不孕症患者,促性腺激素(Gn)启动日B超显示子宫内膜回声异常或内膜厚度>5 mm的患者共69例,其中28例行子宫内膜轻创术者为研究组,41例未行轻创术者为对照组,比较两组患者临床妊娠率、胚胎种植率和活产率的差别。结果:两组患者平均年龄、不孕年限、基础FSH水平、Gn启动剂量、Gn使用天数、Gn总量、HCG日血E2水平、获卵数、受精数、可移植胚胎数和移植胚胎数均无统计学差异(P>0.05),研究组患者临床妊娠率、胚胎种植率和活产率分别为50.00%、28.13%和46.43%,虽然高于对照组的41.46%、23.47%和31.71%,但无统计学差异(P>0.05)。结论:子宫内膜轻创术并不能改善拮抗剂方案体外受精-胚胎移植的治疗结局。

Objective：To explore the effect of endometrial surgery with minimal damage on clinical pregnancy rate,embryo implantation rate and live birth rate of cases receiving in vitro fertilization-embryo transfer（IVF-ET） with GnRH antagonists.Methods：The patients with infertility who were treated with IVF-ET with GnRH antagonists in reproductive center of the hospital from January 2007 to December 2009 were analyzed retrospectively,B-type ultrasound showed that there were 69 patients with abnormality of endometrial echo or the depth of endometrium5 mm on the day of gonadotropin start,28 patients who were treated with endometrial surgery with minimal damage were selected as study group,and the other 41 patients who didn＇t receive endometrial surgery with minimal damage were selected as control group,the differences of clinical pregnancy rate,embryo implantation rate and live birth rate were compared between the two groups.Results：There was no significant difference in the average age,duration time of infertility,basic follicle-stimulating hormone（FSH） level,start dose of gonadotropin,the days of gonadotropin usage,the total dose of gonadotropin,the blood estradiol level on the day of human chorionic gonadotropin（HCG） injection,the number of retrieved oocytes,the fertilization rate,the number of embryo suitable for transfer and the number of transferred embryos between the two groups（P0.05）.The clinical pregnancy rate,embryo implantation rate and live birth rate in study group were 50.00%,28.13% and 46.43%,respectively,which were higher than those in control group（41.46%,23.47% and 31.71%,respectively）,but there was no significant difference（P0.05）.Conclusion：Endometrial surgery with minimal damage can＇t improve the outcome of IVF-ET with GnRH antagonists.