宫腔灌注绒毛膜促性腺激素对反复着床失败后冻融胚胎移植妊娠结局的作用

Effects of intrauterine infusion of human chorionic gonadotropin(hCG) on the clinical outcome before frozen-thawed embryo transfer after repeated implantation failure

目的:探讨胚胎反复着床失败(RIF)后冻融胚胎移植(FET)时行宫腔内灌注基因重组人绒毛膜促性腺激素(rh CG)对妊娠结局的影响。方法:选择既往胚胎RIF再次行FET的208个周期的患者资料进行回顾性分析。将其中FET日宫腔内灌注rh CG为研究组,另按1∶1选择匹配(年龄、既往ET失败次数、不孕类型)对照组。分析比较着床率、自然流产率、生化妊娠率、临床妊娠率、多胎妊娠率。结果:研究组着床率(22.92%)、生化妊娠率(5.77%)、自然流产率(17.78%)均略高于对照组(分别为16.88%、1.92%、16.13%),多胎妊娠率略低于对照组(15.56%vs 19.35%),但差异均无统计学意义(P>0.05)。研究组和对照组均未观察到异位妊娠病例,研究组临床妊娠率显著高于对照组(43.27%vs 29.82%),差异有统计学意义(P<0.05)。结论:FET日行宫腔内灌注rh CG可以提高RIF患者的临床妊娠率。

Objective： To investigate the effect of intrauterine infusion of recombinant human chorionic gonadotropin（rh CG） before frozen-thawed embryo transfer（FET） after repeated implantation failure（RIF）. Methods： Retrospective analysis of 208 cycles from the patients who had RIF of embyo transfer undergoing FET was performed. The intervention group received an intrauterine infusion of h CG before the embryo transfer（n=104）. The control group（n=104） matched to interverntion group（the age difference 〈one year, failure times of embryo transfer matching, the same infertility type） did not receive rh CG. The implantation rates, the biochemical pregnancy rates, the first trimester abortion rates, the multiple pregnancy rates, and the clinical pregnancy rates were compared between the two groups. Results： The implantation rate（22.92%）, the biochemical pregnancy rate（5.77%） and the first trimester abortion rate（17.78%） were higher in the h CG group than in the control（16.88%, 1.92%, 16.13%）, the multiple pregnancy rate was lower in the h CG group than in the control（15.56% vs 19.35%）, but these differences were not statistically significant. The clinical pregnancy rate was higher in the h CG group than in the control（43.27% vs 29.82%）, the difference was statistically significant（P〈0.05）. Conclusion： Intrauterine administration of 500 U h CG before the embryo transfer can be a choice for patients undergoing FET after RIF. But more well-designed prospestive randomized trials are needed.