两种子宫内膜准备方案在年龄小于35岁的多囊卵巢综合征患者冻融胚胎移植中的应用比较

Comparison of two endometrial preparation protocols in freeze-thawed embryo transfer in patients with polycystic ovary syndrome less than 35 years old

目的比较两种子宫内膜准备方案在年龄<35岁的多囊卵巢综合征(PCOS)患者冻融胚胎移植(FET)中的应用效果。方法回顾性分析2008年7月1日至2017年8月31日在郑州大学第三附属医院生殖中心行FET助孕的年龄<35岁的PCOS患者的临床资料。根据子宫内膜准备方案将所有患者分为促排周期组(856例)和人工周期组(1 444例)。比较两组患者的一般资料、移植日内膜厚度、临床妊娠率、流产率、早产率及活产率等指标。结果两组患者的移植胚胎个数、移植胚胎类型差异无统计学意义(均P>0.05);人工周期组移植日子宫内膜厚度高于促排周期组(P<0.05)。两组患者临床妊娠率、异位妊娠率、多胎妊娠率、早产率及活产率等差异无统计学意义(均P>0.05),人工周期组流产率高于促排周期组(P<0.05)。结论对于年龄<35岁的PCOS患者,在FET周期内膜准备时,促排周期方案可能是更好的选择。

Objective To compare the clinical outcome of two endometrial preparation protocols on frozen-thawed embryo transfer(FET) in patients with polycystic ovary syndrome(PCOS) less than 35 years old.Methods The clinical data of PCOS patients less than 35 years old who were assisted by frozen-thawed embryo transfer at the Reproductive Center of the Third Affiliated Hospital of Zhengzhou University from July 1, 2008 to August 31, 2017 were retrospectively analyzed. All patients were divided into ovulation induction cycle group(856 cases) and hormone replace treatment group(1 444 cases) according to different endometrial preparation protocols. The general data, endometrial thickness at the day of the transplant, clinical pregnancy rate, abortion rate, preterm delivery rate and live birth rate were compared between the two groups.Results There was no significant difference in the number of transplanted embryos, type of transplanted embryos between the two groups(all P>0.05). The endometrial thickness of the hormone replace treatment group was significantly higher than that of the ovulation induction cycle group(P<0.05). There was no significant difference in clinical pregnancy rate, ectopic pregnancy rate, multiple pregnancy rate, preterm birth rate and live birth rate between the two groups(all P>0.05), while the abortion rate of the hormone replace treatment group was significantly higher than that of the ovulation induction cycle group(P<0.05).Conclusion The ovulation induction cycle protocol may be a better choice for PCOS patients less than 35 years old, when preparing for FET cycle endometrial preparation.