缩宫素受体拮抗剂阿托西班在解冻胚胎移植中的应用

Application of oxytocin antagonists in thaw embryo transfer

【摘要】目的探讨缩宫素受体拮抗剂——阿托西班对解冻胚胎移植后妊娠结局的影响。方法选取2012年7月至12月就诊于天津医科大学总医院生殖中心行解冻胚胎移植的患者120例，随机分为阿托西班组60例和对照组60例。120例患者每例均移植解冻后第3天的优质7～8细胞胚胎2～3枚。阿托西班组患者在移植前30min开始给予37．5mg阿托西班，加入0．9％盐水250ml中静脉滴注，2h输完，对照组移植前不予特殊治疗，两组移植后均常规给予黄体酮行黄体支持。比较两组患者临床妊娠率、胚胎种植率、早期流产率，并记录阿托西班组不良反应发生情况。结果阿托西班组临床妊娠率为60％（36／60），胚胎种植率为30．0％（48／160），均高于对照组的42％（25／60）和20．3％（31／153），两组分别比较，差异均有统计学意义（P〈0．05）。阿托西班组早期流产率6％（2／36），对照组16％（4／25），两组比较，差异无统计学意义（P〉0．05）。阿托西班组治疗中及治疗后未见不良反应。结论胚胎移植前给予阿托西班治疗能有效改善解冻胚胎移植妊娠结局，提高妊娠率和胚胎种植率，不增加早期流产的风险，未发生明显不良反应。

Objective To study the effects of oxytocin antagonists - atosiban on pregnancy outcome after thaw embryo transfer （TET）. Methods Between Jul. and Dee. 2012, a total of 120 women undergoing TET in Reproductive Medical Center, General Hospital of Tianjin Medical University were randomly allocated into atosiban and control group. They were all transferred 2 or 3 top quality embryos at phase of 7-8 cells . Patients in atosiban group were administered by intravenous administration of atosiban before 30 minutes of embryo transfer with a total administered dose of 37.5 mg. In the control group, no special treatment was given before embryo transfer. All patients in 2 groups underwent progesterone luteal support regularly after embryo transfer, then the clinical rate of pregnancy, implantation and early abortion was compared. Results The clinical pregnancy rate per cycle and implantation rate per transfer were 60% （36/60） and 30. 0% （48/160） in the atosiban group, which were higher than 42% （25/60） and 20. 3% （31/153） in the control group （all P 〈 0. 05）. Early abortion rate was 6% （2/36）in the atosiban group, which was no statistical difference comapring with control group [ 16% （ 4/25 ）, P 〉 0. 051. Conclusion It was suggested that atosiban treatment before embryo transfer can improve the outcome of pregnancy, and increase clinical pregnancy rate and implantation rate after TET.