定坤丹对复苏周期子宫内膜及妊娠结局的影响

Clinical effects of Dingkundan on endometrial preparation and pregnancy outcome for frozen-thawed embryo transfer cycles

目的探讨冻融胚胎移植周期中定坤丹对子宫内膜及妊娠结局的影响。方法将2016年7月至2017年6月于西京医院妇产科生殖医学中心接受冻融胚胎移植的121个周期,按内膜准备过程中是否使用定坤丹分为两组:A组:补佳乐+芬吗通+定坤丹(67个周期),B组:补佳乐+芬吗通(54个周期)。回顾性分析两组患者年龄、不孕年限、体重指数、转化日子宫内膜厚度和类型、临床妊娠率、胚胎种植率等结局的差异。结果两组患者年龄、不孕年限、体重指数、复苏周期数、移植胚胎数、基础激素水平[卵泡刺激素(FSH)、促黄体素(LH)、雌激素(E_2)、泌乳素(PRL)、睾酮(T)]比较均无统计学差异(t=0.16~1.75,均P>0.05),A组孕酮(P)水平显著高于B组(t=2.58,P<0.05)。冻融胚胎移植(FET)周期中,两组临床妊娠率、种植率比较均无显著性差异(χ~2值分别为0.03、0.31,均P>0.05),转化日子宫内膜厚度、移植日P水平比较均无显著性差异(t值分别为0.76、0.89,均P>0.05),A组患者中B型子宫内膜比率高于B组患者,但无统计学差异(χ~2=4.47,P>0.05),且移植日E_2水平高于B组患者,但无统计学差异(t=0.47,P>0.05)。结论冻融胚胎移植周期中添加定坤丹对转化日子宫内膜厚度和类型及临床妊娠率、胚胎种植率无显著影响,但一定程度上可增加移植日E_2的水平和B型子宫内膜的比例。

Objective To investigate the effects of Dingkundan on the endometrial preparation and pregnancy outcome for frozen- thawed embryo transfer cycles （FET）. Methods Totally 121 FET cycles were analyzed retrospectively from July 2016 to June 2017. All cases were divided into two groups according to whether Dingkundan was used in FET cycles or not. Group A was provided with progynova ＋Femoston ＋Dingkundan （67 cycles）, while group B was provided with progynova＋ Femoston （54 cycles）. Patients＇ age, duration of infertility, body mass index （BMI）, endometrial thickness and type on the day of progesterone initiation, implantation rate and clinical pregnancy rate were compared between two groups. Results Patients＇ age, duration of infertility, BMI, cycle, number of embryo transfer, basic hormone level （FSH, LH, E2, PRL, T） were not significantly different between two groups （t value ranged 0.16-1.75, all P〉0.05）. The level of P in group A was significantly higher than that in group B （t= 2.58, P〈0.05）. In FET clinical pregnancy rate and implantation rate between two groups were not statistically significant （Z2 value was 0.03 and 0.31, respectively, both P〉0.05）, and the difference in endometrial thickness on the day of progesterone initiation and P level on implantation day was not obvious （t value was 0.76 and 0.89, respectively, both P〉0.05）. The rate of type B endometrium in group A was higher than that of group B, but the difference was not significant （χ^2 =4.47, P〉0.05）, and E2 level on implantation day was higher than in group B （t = 0.47, P 〉0.05）. Conclusion In hormone replacement cycle for FET, supplement of Dingkundan has no effect on endometrial thickness and type on the day of progesterone initiation, clinical pregnancy rate and implantation rate. But it may increase the level of E2 on the day of implantation and the rate of type B endometrium in some extent.