雌激素恒量替代周期在冻融胚胎移植术中的应用

Application of estrogen constant replacement cycle in frozen-thawed embryo transfer

目的探讨雌激素恒量替代周期在冻融胚胎移植中的疗效及应用价值。方法将329例替代周期冻融胚胎移植患者随机分为雌激素恒量替代周期组(A组)和雌激素递增替代周期组(B组),A组进一步分为降调节组(A1组)和无降调节组(A2组),B在进一步分为降调节组(B1组)和无降调节组(B2组)。比较4组患者的用药时间、注射黄体酮日的内膜厚度、雌二醇(E2)值、妊娠率及流产率。结果 A组用药时间显著短于B组,内膜厚度及E2值显著大于B组;A组内膜厚度<8 mm的患者比例明显少于B组;A1组患者用药时间显著长于A2组,且E2值显著低于A2组;B1组患者E2值显著低于B2组。结论雌激素恒量替代周期FET切实可行,可简化替代周期内膜准备方法,提高患者依从性,简化服药方法,缩短服药时间,但不影响妊娠率。

Objective To investigate the clinical effects and application value of estrogen constant replacement cycle in frozen-thawed embryo transfer（FET）.Methods Three hundred and twenty-nine patients conducted replacement cycle FET were randomly divided into estrogen constant replacement cycle group（group A） and estrogen increasing replacement cycle group（group B）.Group A was further divided into down-regulation group（group A1） and non-down-regulation group（group A2）,and group B into down-regulation group（group B1） and non-down-regulation group（group B2）.The administration time,intimal thickness on the day of progesterone injection,estrogen（E2） value,rates of pregnancy and abortion in four groups were compared.Results The administration time of group A was markedly shorter than that of group B,while its intimal thickness and E2 value were significantly larger than those of group B.The proportion of patients with intimal thickness 8 mm in group A was obviously less than that in group B.The administration time of patients in group A1 was notably longer than that in group A2,and its E2 value significantly lower than that of group A2.E2 value in patients in group B1 was remarkably lower than that in group B2.Conclusion Estrogen constant replacement cycle FET is practicable.It can simplify the intimal preparation of replacement cycle and administration of drugs,improve patients′ compliance and shorten the time of administration,but the pregnancy rate is not affected.