金凤丸联合长效促性腺激素释放激素激动剂在冻融胚胎移植中的应用

Application of Jinfeng pill combined with long-acting gonadotropin-releasing hormone agonist for frozen-thawed embryo transfer

目的探讨金凤丸联合长效促性腺激素释放激素激动剂(GnRH-a)在冻融胚胎移植(FET)中的应用价值。方法回顾分析2017年1月1日至2017年12月31日期间于河北医科大学第二医院生殖医学科行FET的220例患者的临床资料,根据是否联合应用金凤丸准备内膜分为金凤丸联合长效GnRH-a组(试验组,n=102)和单纯GnRH-a组(对照组,n=118)。比较两组患者的一般资料及胚胎复苏率、移植胚胎数、胚胎种植率、临床妊娠率、子宫内膜增殖时间、子宫内膜转化日血清雌二醇水平及子宫内膜转化日子宫内膜厚度。结果试验组患者与对照组患者相比,其子宫内膜增殖时间较短[(14.03±3.39)d比(16.40±1.45)d]、子宫内膜转化日血清雌二醇水平较高[(347.67±26.78)ng/L比(259.57±24.78)ng/L]、子宫内膜转化日子宫内膜较厚[(11.89±1.57)mm比(9.69±0.85)mm],差异均有统计学意义(P<0.001);试验组胚胎种植率及临床妊娠率均较高(32.66%比31.70%;53.92%比50.85%),但差异均无统计学意义(P>0.05)。患者年龄、不孕年限、原发不孕比例、抗苗勒管激素(AMH)、窦卵泡计数(AFC)、体质量指数(BMI)、解冻次数、胚胎复苏率、移植胚胎数、多胎妊娠率组间比较,差异均无统计学意义(P>0.05)。结论金凤丸联合长效GnRH-a可以改善FET的妊娠结局。

Objective To investigate the application value of Jinfeng pill combined with long-acting gonadotropin-releasing hormone agonist(GnRH-a)in frozen-thawed embryo transfer(FET).Methods A retrospective analysis of 220 cases of FET in the Department of Reproductive Medicine,the Second Hospital of Hebei Medical University during January 1,2017 and December 31,2017 was performed.All cases were divided into Jinfeng pill combined with long-acting GnRH-a group(experimental group,n=102)and long-acting GnRH-a group(control group,n=118)according to whether the endometrium was prepared in combination with Jinfeng pill or not.The general data,embryo resuscitation rate,number of transplanted embryos,embryo implantation rate,clinical pregnancy rate,endometrial proliferation time,serum estradiol level on the day of endometrial transformation and endometrial thickness on the day of endometrial transformation were compared between the two groups.Results Compared with control group,the experimental group had a shorter endometrial proliferation time[(14.03±3.39)d vs.(16.40±1.45)d,P<0.001],and the serum estradiol level was higher[(347.67±26.78)ng/L vs.(259.57±24.78)ng/L,P<0.001].The endometrium on the endometrial transformation was thicker[(11.89±1.57)mm vs.(9.69±0.85)mm,P<0.001],the difference was statistically significant.The embryo implantation rate and the clinical pregnancy rate in experimental group were higher than those in control group(32.66%vs.31.70%;53.92%vs.50.85%),but the difference was not statistically significant(P>0.05).There were no significant differences in age,infertility duration,primary infertility ratio,anti-Müllerian hormone(AMH),antral follicle count(AFC),body mass index(BMI),number of thawing,embryo resuscitation rate,number of transplanted embryos,and multiple pregnancy rates between the two groups(P>0.05).Conclusion Jinfeng pill combined with long-effect GnRH-a can improve the pregnancy outcome of FET.