短效促性腺激素释放激素激动剂对冻融周期妊娠结局的影响

Effects of short-acting GnRHa on pregnancy outcome in frozen-thawed embryo transfer cycles

目的探讨短效促性腺激素释放激素激动剂（GnRHa）对冻融周期妊娠结局的影响。方法回顾性分析冻融胚胎移植（FET）838个周期的临床资料，其中自然周期210个，激素替代周期628个。按移植后是否应用GnRHa分为：自然周期移植后用GnRHa组（72个），自然周期移植后未用GnRHa组（138个），激素替代周期移植后用GnRHa组（111个），激素替代周期移植后未用GnRHa组（517个）。分别比较自然周期和激素替代周期GnRHa组和未用GnRHa组患者的临床妊娠结局。结果自然周期移植后用GnRHa组临床妊娠率（61．11％）和胚胎着床率（40．85％）高于自然周期移植后未用GnRHa组（44．93％、30．26％，P〈0．05）。而激素替代周期中，应用GnRHa对妊娠结局未见改善。结论移植后给予GnRHa对自然周期FET患者可显著提高妊娠率和着床率，而对激素替代周期并无明显效果。

Objective To investigate the effect of short-acting gonadotrophin releasing hormone agonist （GnRHa） on pregnancy outcome in frozen-thawed embryo transfer （FET）. Methods The retro- spective analysis was based on 838 FET cycles including 210 natural cycles and 628 hormone replacement cycles. According to whether use GnRHa after transfer as luteal phase support, these cycles were divided into natural cycles with GnRHa group （n = 72）, natural cycles without GnRHa group （n = 138 ）, hor- mone replacement cycles with GnRHa group （ n = 111 ）, and hormone replacement cycles without GnRHa group （n =517）. The clinical pregnancy outcomes were compared between natural cycles with GnRHa group and natural cycles without GnRHa group, hormone replacement cycles group and hormone replace- ment cycles without GnRHa group respectively. Results In natural cycles with GnRHa group, the preg- nancy rate （61.11%） and implantation rate （40. 85% ） were significantly higher than those in natural cycles without GnRHa group （44.93% , 30.26% ）. But in hormone replacement cycles, the use of Gn- RHa as luteal phase support did not improve the pregnancy outcome. Conclusions Administration of GnRHa can increase clinical and implantation rates in natural frozen-thawed embryo transfer cycles. But it is useless in the hormone replacement cycles.