冻融胚胎移植周期移植时机对反复种植失败患者妊娠结局的影响

Effect of Frozen Thawed Embryo Transfer Cycle and Transplantation Time on Pregnancy Outcome in Patients with Repeated Implant Failure

【目的】分析冻融胚胎移植（frozen-thawed embryo transfer，FET）周期时机对反复种植失败（repeated implantation failure，RIF）患者妊娠结局的影响。【方法】选择本院收治的80例行FET的RIF患者作为研究对象，随机分为对照组与观察组各40例，均采用降调节联合激素替代方案进行FET，对照组待孕酮作用内膜3d后移植胚胎，观察组延迟4～5d行胚胎移植，比较两组性激素水平的变化及妊娠结局的差异。【结果】①两组移植胚胎数、移植优质胚胎数、移植日子宫内膜厚度对比差异无统计学意义（P〉0．05）；②移植前，两组性激素水平对比差异无统计学意义（P〉0．05），移植日，观察组促黄体生成素（LH）、卵泡刺激素（FSH）、孕酮（P）水平均低于对照组，雌二醇（E2）水平高于对照组（P〈0．05）；③观察组临床妊娠率高于对照组（P〈0．05），其胚胎种植率略高于对照组，早期流产率、异位妊娠率、多胎妊娠率均略低于对照组，但对比差异无统计学意义（P〉0．05）。【结论】采用降调节联合激素替代方案进行FET延迟移植时机可提高RIF患者子宫内膜客受性，提升其临床妊娠率。

[Objective]To analyze the effect of frozen-thawed embryo transfer （FET） cycle time on pregnancy outcome in patients with repeated RIF failure （repeated implantation failure）.[Methods] A total of 80 patients with RIF un- dergoing FET in the hospital were randomly divided into control group and observation group, 40 cases in each group. The combination of down-regulation and hormone replacement was used for FET; In the control group, the embryos were transplanted at 3 d after progesterone administration; The observation group was delayed 4-5 D and underwent embryo transfer, and the changes of sex hormone levels and pregnancy outcomes were compared between the two groups.IRe- suits] （1）There was no significant difference between the two groups in the number of embryos transferred, the number of high-quality embryos transferred, and the thickness of endometrium on the day of transplantation （ P〉0.05）. （2）Before transplantation, there was no statistically significant difference in sex hormone levels between the two groups （ P 〉 0.05）. On the day of transplantation, the levels of luteinizing hormone （LH）, follicle stimulating hormone （FSH） and progesterone （P） in observation group were lower than those in the control group, while estradiol （E2） level was higher than that in the control group （ P 〈0.05）. （3）The clinical pregnancy rate of the observation group was higher than that of the control group （ P〈0.05）, and the embryo implantation rate was slightly higher than that in the control group. The rates of early abortion, ectopic pregnancy and multiple pregnancy were slightly lower than those in control group （ P〈0.05）. [Conclusion]The delayed application of down regulation combined with hormone replacement for FET can improve the endometrial receptivity and the clinical pregnancy rate of patients with RIF.