降调节后雌孕激素替代内膜准备方案对改善PCOS患者FET结局的临床研究

Improvement of pregnancy outcomes of frozen thawed embryo transfer cycle with GnRHa use followed by hormone replacement in patients with polycystic ovary syndrome

目的:探讨降调节后雌孕激素替代(HRT)内膜准备方案对改善多囊卵巢综合征(PCOS)患者冻融胚胎移植(FET)结局的作用。方法:回顾性分析190例PCOS患者行FET190个周期临床资料,根据内膜准备方案分为HRT组98个周期和降调节HRT组92个周期,比较两组胚胎种植率、妊娠率、流产率、异位妊娠率、多胎率、分娩率和生殖激素水平的差异。结果:HRT组和降调节HRT组的种植率分别为35.8%和51.9%,临床妊娠率分别为51.0%和70.6%,差异均有统计学意义(P<0.05);HRT组和降调节HRT组流产率、多胎率、异位妊娠率和分娩率无统计学差异(P>0.05);而降调节HRT组黄体酮注射日、FET前1天和FET后第3天LH水平低于HRT组(P<0.05)。结论:3.75mg促性腺激素释放激素激动剂(GnRHa)降调节后HRT内膜准备方案能够改善PCOS患者FET种植率和妊娠率。

Objective：To explore the pregnancy outcome of frozen-thawed embryo transfer cycle with 3.75 mg of GnRHa followed by hormone replacement in patients with polycystic ovary syndrome（PCOS）.Methods：A total of 190 patients with PCOS seeking for frozen-thawed embryo transfer were divided into two groups.Women in group A were given hormone replacement（n=98）and those in group B used 3.75 mg of GnRHa combined with hormone replacement（n=92）according to the endometrial preparation.The differences in implantation rate,pregnancy rate,miscarriage rate and reproductive hormone levels between the two groups were evaluated.Results：Compared with group A,women in group B achieved significantly higher pregnancy rate（70.6%vs.51.0%,P〈0.05）,higher implantation rate（51.9%vs.35.8%,P〈0.05）,and significantly lower luteinizing hormone level during the treatment.No significant differences were found between group A and group B in early abortion rate,ectopic pregnancy rate,multiple fetal rate and live birth rate（Pall〉0.05）.Conclusion：The hormone replacement after 3.75 mg of GnRHa could improve PCOS frozen embryo transfer implantation rate and pregnancy rate.