来曲唑联合激素替代方案在月经不规律患者冻融胚胎移植中的临床应用

Letrozole combined with hormone replace treatment endometrial preparation protocols application in irregular patients for frozen-thawed embryo transfer

目的:研究对于月经不规律患者行冻融胚胎移植(FET)时,比较使用来曲唑联合激素替代方案与其他内膜准备方案的结局。方法:回顾性分析2013年6月至2014年12月在本院生殖医学中心月经不规律的患者行FET治疗的361个周期,依据内膜准备方案不同分为三组,其中使用激素替代方案者为A组,共229个周期,来曲唑联合尿促性腺激素(HMG)促排卵方案者为B组,共84个周期,使用来曲唑联合激素替代方案为C组,共48个周期。比较三种不同内膜准备方案对月经不规律患者行FET的临床结局。结果:三组间年龄、不孕年限及基础内分泌比较差异均无统计学意义(P>0.05)。三组间的转化日内膜、激素水平、胚胎复苏率以及优胚率的差异均无统计学意义(P>0.05)。来曲唑促排卵联合激素替代周期组(C组)在临床妊娠率及种植率(66.67%、51.85%)均高于其他两组(56.89%及42.10%,56.79%及44.59%),但差异无统计学意义(P>0.05)。三组的移植胚胎个数、多胎妊娠率、异位妊娠率差异均无统计学意义(P>0.05)。结论:对于月经不规律患者行冻融胚胎移植时,来曲唑促排卵联合激素替代内膜准备方案与常规激素替代方案及促排卵方案一样获得良好的临床妊娠率,可作为促排卵准备内膜时的一种补充方案,为临床上的用药提供更多更灵活的选择。

AIM： To compare the clinical out-come effect of three endometrial preparation proto- cols in irregular menstruation patients for frozen- thawed blastocyst transfer. METHODS： Three hun- dred and sixty-one FET cycles were analyzed retro- spectively from June 2013 to December 2014. All cases were divided into three groups： 229 hormone replace treatment protocol group （group A）, 84 o- vulation induction protocol group （group B ）, 48 letrozole combined with hormone replace treatment protocol group （ group C）. Patient＇s age, basic en- docrine, endometrial thickness on the day of proges- terone initiation, high quality embryo rate, mean number of embryo transferred per patient, implanta- tion rate, clinical pregnancy rate, early abortion rate and ectopic pregnancy rate were compared among the three groups. RESULTS：linical pregnancy rate and implantation rate of group C （66.67%, 51.85% ） were higher than the other two groups （56.89% and 42.10% ,56.79% and 44.59% ,respectively）, but there were no statistically signifi- cant difference （ P 〉 0.05 ）. There was no signifi- cant difference in the other indicators among the three groups. CONCLUSION： In irregular men- struation patients for frozen-thawed embryo transfer, the use of Letrozole combined with hormone replace treatment endometrial preparation protocol can obtain the similar pregnancy rate compared with artificial endometrium protocol or ovulation induction proto- col. So Letrozole combined with hormone replace treatment endometrial preparation protocol can be used as a effective clinical method for the patients , which will be cancelled for the failed endometrium prepare.