冻融胚胎移植周期不同方案血P/E_2水平与妊娠结局关系

The relationship between progesrone-estradiol ration and the pregnancy outcomes in the different cycles of FET

目的探讨冻融胚胎移植周期不同内膜准备方案血清P/E_2水平与妊娠结局的关系。方法对郑州大学附属洛阳中心医院自2014年1月至2015年1月行冻融胚胎解冻移植678周期进行总结分析。根据内膜准备方案不同分为自然周期组(118例),激素替代周期组(511例),降调节+激素替代周期组(49例),比较各组移植当日激素水平。根据临床结局分为临床妊娠组(364例),未妊娠组(314例),根据是否活产分为活产组(213例),未活产组(465例),分别比较各组移植日激素水平。结果三种内膜准备方案临床妊娠率和活产率差异无统计学意义(P>0.05),激素替代周期组雌激素水平明显高于降调节激素替代周期组和自然周期组,差异有统计学意义(P<0.05);自然周期组、激素替代周期组孕激素水平明显高于降调节激素替代周期组,差异均有统计学意义(P<0.05);自然周期组P/E_2水平明显高于降调节激素替代周期组和激素替代周期组,差异均有统计学意义(P<0.05)。妊娠组与非妊娠组,活产组与非活产组间内膜厚度差异无统计学意义(P>0.05),孕激素和孕雌激素比值在妊娠组和活产组均分别明显高于非妊娠组和非活产组,而雌激素均分别明显低于非妊娠组和非活产组,差异均有统计学意义(P<0.05)。46.16<P/E_2≤94.16组临床妊娠率和活产率均高于其余三组,差异有统计学意义(P<0.05)。结论雌孕激素比值可能通过内膜容受性影响临床妊娠结局。

Objective： To study the relationship between Progesrone-Estradiol Ration and the pregnancy outcomes in the different cycles of FET. Methods： In 678 cycles who underwent FET. According to the preparation of endometrium, the patients were divided into three groups： natural cycle group （118 cases） , hormone replacement cycle group （511cases） , down - regulation ＋ hormone replacement cycle group （49cases） , The levels of hormones were compared between the three groups. According to whether the live birth is divided into live birth group （213 cases） , not live group （465 cases） , respectively, compared with each group on the day of hormone levels. Results： There was no significant difference in clinical pregnancy rate and live birth rate between the two groups （P〉0.05） . The estrogen level of the hormone replacement cycle group was significantly higher than that of the down-regulating hormone replacement cycle group and the natural cycle group, the difference was statistically significant. There was no significant difference of endometrial thickness between pregnant group and non - pregnant group, live group and non - live group （P〉0.05） The progesterone and P/E2 were significantly higher in the pregnant group and in the live group than in the non-pregnant group and the non-live group respectively, and the estrogen was significantly lower than that of the non-pregnant group and the non-pregnant group respectively （P〈0.05） . 46.16 〈P / E2≤94.16 group clinical pregnancy rate and live birth rate were higher than the other three groups, the difference was statistically significant （P〈0.05） . Conclusion： Estrogen and progesterone ratio may affect endometrial receptivity in clinical pregnancy outcomes.