补肾调周法对体外受精-胚胎移植失败患者子宫内膜容受性及移植结局的改善作用研究

Improvement Research of Applying Tonifying Kidney and Regulating Menstrual Cycle Method on Endometrial Receptivity and Transplant Outcome for Patitents with Failed IVF-embryo Transfer

目的:观察补肾调周法对体外受精-胚胎移植失败患者子宫内膜容受性及移植结局的改善作用。方法:选取2016年3月~2019年3月新疆医科大学附属中医医院收治的97例体外受精-胚胎移植失败患者作为研究对象,采取简单随机化方法分为对照组48例和观察组49例,对照组患者服用戊酸雌二醇,观察组患者在服用戊酸雌二醇的同时采用补肾调周法,2组均在3个月后进行胚胎移植周期治疗。比较2组患者治疗前后子宫内膜厚度、形态类型和血流类型,同时比较临床妊娠率及不良反应情况。结果:治疗后2组患者子宫内膜厚度均增加,且观察组大于对照组,差异有统计学意义(P<0.05);治疗后对照组患者A型、B型、C型占比与治疗前比较差异均无统计学意义(P>0.05),治疗后观察组患者B型占比升高,A型、C型占比均降低,且观察组患者B型占比高于对照组,A型、C型占比均低于对照组,差异均有统计学意义(P<0.05);治疗后对照组患者Ⅰ型、Ⅱ型、Ⅲ型占比与治疗前比较差异均无统计学意义(P>0.05),治疗后观察组患者Ⅱ型、Ⅲ型占比均升高,Ⅰ型占比降低,且观察组患者Ⅱ型、Ⅲ型占比均高于对照组,Ⅰ型占比低于对照组,差异均有统计学意义(P<0.05);观察组临床妊娠率为67.35%,高于对照组的33.33%,差异有统计学意义(P<0.05);观察组不良反应发生率为18.75%,对照组为16.67%,2组比较差异无统计学意义(P>0.05)。结论:补肾调周法治疗体外受精-胚胎移植失败患者可增加子宫内膜厚度,改善子宫内膜形态、血流类型,提高临床妊娠率且安全可靠。

Objective:To explore the effect of tonifying kidney and regulating menstrual cycle on the endometrial receptivity and transplantation outcome of patients with failed IVF-embryo transfer.Methods:97 patients with failed IVF-embryo transplantation treated in the hospital from March 2016 to March 2019 were selected as the research subjects.They were divided into 48 cases in a controlled group and 49 cases in an observation group by a simple randomization method.Estradiol acid,the observation group of patients taking estradiol valerate at the same time using kidney tonifying method,both groups in 3 months after the embryo transfer cycle treatment.Endometrial thickness,morphological type,and blood flow type were compared between the two groups of patients before and after treatment,while clinical pregnancy rates and adverse reactions were compared.Results:After treatment,the endometrial thickness of the two groups increased,and the observation group was larger than the controlled group,and the difference was statistically significant(P<0.05).There was no significant difference in comparison(P>0.05).After treatment,the proportion of patients with type B in the observation group increased,while the proportion of types A and C decreased.The proportion of patients with type B in the observation group was higher than that in the controlled group,and type A and C accounted for less than the controlled group,and the differences were statistically significant(P<0.05),the proportions of typeⅠ,typeⅡ,and typeⅢpatients in the controlled group after treatment were not significantly different from those before treatment(P>0.05).After treatment,the proportion of typeⅡand typeⅢin the observation group increased,and the proportion of typeⅠdecreased.In the observation group,the proportion of typeⅡand typeⅢwas higher than the controlled group,and the proportion of typeⅠwas lower than the controlled group,the difference was statistically significant(P<0.05),the clinical pregnancy rate in the observation group was 67.35%,which was higher than 33.33%in the controlled group,the difference was statistically significant(P<0.05),the incidence of adverse reactions in the observation group was 18.75%,The controlled group was 16.67%,there was no significant difference between the two groups(P>0.05).Conclusion:The method of tonifying kidney and regulating menstrual cycle in the treatment of patients with failed IVF-embryo transfer can increase the thickness of the endometrium,improve the endometrial morphology and blood flow type,increase the clinical pregnancy rate and is safe and reliable.