人工周期中使用雌激素天数对冻融胚胎移植结局的影响

Effect of estrogen given days on the outcome of frozen-thawed blastocyst transfer for patients with regular menstruation in hormone replacement cycles

目的 通过对月经规律患者冻融胚胎移植（FET）人工周期准备子宫内膜的临床结局分析,探讨人工周期雌激素应用天数与妊娠结局的关系. 方法 回顾性分析武汉同济医院生殖中心2011年12月至2012年8月以人工周期准备子宫内膜,B超监测子宫内膜厚度≥8 mm时行复苏移植2个优质囊胚的月经规律患者共153个周期的临床资料.用黄体酮前雌激素应用天数按2分隔点分为≤15d组和＞15 d组,比较不同雌激素应用天数的一般情况和妊娠结局;并对超出理想内膜增生期的天数按3分隔点分为＜0、0～3和＞3 d组,比较三组间的一般情况和妊娠结局. 结果 （1）黄体酮转化前用雌激素总天数＞15 d组的流产率高于≤15d组,继续妊娠率低于≤15d组,但两组间胚胎着床率、临床妊娠率、流产率、继续妊娠率均无统计学差异（P＞0.05）;（2）应用雌激素超出理想内膜增生期0～3 d组的胚胎着床率、临床妊娠率、继续妊娠率稍高于其他两组,而流产率稍低于其他两组,但三组间妊娠结局无统计学差异（P＞0.05）. 结论 人工周期是一种较好的FET内膜准备方法,雌激素应用天数未显著影响妊娠结局,雌激素最佳应用天数有待增加样本量进一步研究.

Objective：To explore the optimum estrogen given days in frozen-thawed blastocyst transfer cycle for patients with regular menstruation in hormone replacement cycles.Methods：A retrospective study was conducted in 153 frozen-thawed blastocyst transfer cycles of patients with regular menstruation in hormone replacement cycles in Wuhan Tongji Reproductive Medicine Center from Dec.2011 to Aug.2012.In each cycle,two high quality blastocysts were transferred,and endometrium thickness was more than 8 mm.The cycles were divided into two groups according to estrogen given days..≤15 days group and ＞15 days group.The cycles were also divided into three groups according to the number of days beyond the ideal endometrial hyperplasia period：＜0 day group,0-3 day group and ＞3 days group.The pregnancy outcomes were compared among these groups.Results：There were no significant differences in the implantation rate,clinical pregnancy rate,abortion rate and ectopic pregnancy rate between ≤15 days group and ＞15 days groups（P＞0.05）,but the abortion rate was higher and continue pregnancy rate was lower in ＞15 days group.The clinical outcomes had no difference among the three groups according to the number of days beyond the ideal endometrial hyperplasia period（P＞0.05）,but the clinical outcomes were optimum in 0-3 day group.Conclusions：The estrogen given days do not influence clinical outcomes.