两种机械刺激子宫内膜方法对反复着床失败患者妊娠结局的影响

The Application of two Endometrial Mechanical Stimulation Methods in Patients with Repeated Implantation Failure

目的:探讨两种机械刺激子宫内膜方法在反复着床失败患者中的临床应用价值。方法:选取本中心反复着床失败,拟再次行冻融胚胎移植的患者,随机分成3组:搔刮组(45例):月经期行子宫内膜搔刮;轻微吸刮组(42例):采用宫腔组织吸引管行子宫内膜吸刮;对照组(40例):未特殊处理,所有患者均按常规行冻融胚胎移植,比较3组妊娠结局。结果:搔刮组黄体酮转化日A型内膜比例较高,胚胎着床率及临床妊娠率(27.27%,46.67%)均高于轻微吸刮组(12.75%,21.43%)及对照组(11.46%,20.0%),差异有统计学意义(P<0.05);轻微吸刮组的胚胎着床率及临床妊娠率虽高于对照组,但差异无统计学意义。结论:机械刺激子宫内膜能改善子宫内膜容受性,与轻微吸刮术相比,子宫内膜搔刮术更能明显提高反复着床失败患者的临床妊娠率。

Objective To explore the clinical application of two endometrial mechanical stimulation methods in patients with repeated implantation failure（RIF） in frozen-thawed embryo transfer（FET） cycle.Methods A total of 127 women with RIF who planned to perform FET again were included. They were separated into 3 groups： Group A（45 cases） with endometrial scratching and group B（42 cycles） with endometrial sucking within menstrual period in FET cycle, while in control group C（40 cases）, no endometrial mechanical stimulation was performed. The outcomes of pregnancy were compared. Results The endometrial types of endometrial scratching group were mainly type A. The embryo implantation rate and clinical pregnancy rate in group A（27.27%,46.67%） were significantly higher than those in group B（12.75 %, 21.43%） and group C（11.46%, 20.0%）（P 0.05）. Conclusion The endometrial mechanical stimulation can improve the endometrial receptivity, compare with endometrial sucking, endometrial scratching can improve the clinical pregnancy rate of RIF patients more obviously.