少量hMG联合芬吗通阴道给药在宫腔粘连术后内膜生长不良患者冻胚移植周期中的应用

Application of low-dose human menopausal gonadotropin combined with vaginal administration of Femoston after surgery of intrauterine adhesion in patients with poor endometrial development during frozen-thawed embryo transfer cycles

目的探讨宫腔粘连术后内膜生长不良患者应用小剂量尿促性腺激素(h MG)联合芬吗通阴道放药对冻融胚胎移植妊娠结局的影响。方法回顾性分析2012年1月-2016年5月在第二军医大学长海医院生殖医学中心因宫腔粘连术后内膜生长不良择期行冷融胚胎移植的患者资料共38个周期。根据内膜准备方案随机分为两组:A组口服补佳乐组(22例),B组小剂量hMG+芬吗通阴道给药组(16例),比较各组患者年龄、不孕年限、体质量指数、转化日内膜厚度、冷冻胚胎复苏率、优质胚胎率、移植胚胎数、内膜转化日血清雌二醇(E_2)浓度、妊娠率、早期流产率及周期取消率的差异。结果 B组患者内膜增厚值及血清E_2水平均明显高于A组,差异有统计学意义(P<0.05)。B组患者临床妊娠率较A组明显增加,差异有统计学意义(P<0.05);两组患者年龄、不孕年限、体质量指数、平均移植胚胎数、移植优质胚胎数、冷冻胚胎复苏率、流产率及周期取消率比较,差异无统计学意义(P>0.05)。结论宫腔粘连术后患者冻融胚胎移植中,采用小剂量hMG促排卵联合芬吗通阴道给药,能增加内膜厚度,提高妊娠率和着床率。

Objective To explore the effect of low-dose human menopausal gonadotropin （hMG） combined with vaginal administration of Femoston after surgery of intrauterine adhesion on pregnancy outcomes of frozen-thawed embryo transfer. Methods The data of patients receiving frozen-thawed embryo transfer （38 cycles） due to poor endometrial development after surgery of intrauterine adhesion in Center for Reproductive Medicine in the hospital from January 2012 to May 2016 was analyzed retrospectively, then the patients were divided into two groups according to the protocol of endometrial preparation： 22 patients in group A were treated by oral administration of Progynova, and 16 patients in group B were treated by low-dose hMG combined with vaginal administration of Femoston. Age, duration time of infertility, body mass index （BM1） , endometrial thicknesses on the day of progesterone initiation, recovery rates of thawed embryos, the rates of high-quality embryos, the numbers of embryos transferred, the levels of selxtm estradiol （ E2 ） on the day of progesterone initiation, clinical preg- nancy rates, early abortion rates, and cycle cancellation rates were compared between the two groups. Results The thickening value of endometrium and the leveD of serum E2 in group B were statistically significantly higher than those in group A （ P〈0. 05 ） . The clinical pregnancy rate in group B was statistically significantly higher than that in group A （P〈0. 05 ） . There was no statistically significant difference in age, duration time of infertility, BMI, the mean number of embryos transferred, the number of high-quality embryos, the recovery rate of thawed enlbryos, abortion rate, and cycle cancellation rate between the two groups （ P〉0.05 ） . Conclusion During frozen embryo transfer cycles of patients after surgery of intrauterine adhesion, low-dose hMG combined with vaginal administration of Femoston can increase endo- metrial thickness and elevate pregnancy rate and implantation rate.