降调日加用生长激素预处理在反复种植失败患者中的应用效果

Application efficacy of additional preconditioning with growth hormone ondown-regulation day in patients with repeated implantation failure

目的探讨降调日加用生长激素预处理在反复种植失败患者中的应用效果。方法将138例反复种植失败的不孕患者,分为观察组88例和对照组50例。两组均接受黄体中期长方案促排卵和体外受精-胚胎移植(IVF-ET),仅观察组同时在降调日加用生长激素。比较观察组和对照组的IVF-ET相关临床数据、妊娠结局,观察组本周期和前一周期的IVF-ET相关临床数据,以及观察组移植成功和失败者的IVF-ET相关临床数据。结果与前一周期相比,观察组本周期促性腺激素(GnH)启动量、人绒毛膜促性腺激素(hCG)日雌二醇水平更高,含2个原核的受精卵数、优质胚胎数更多,hCG日内膜厚度更厚(均P<0.05)。与对照组相比,观察组hCG日≥15 mm的卵泡数及优质胚胎数更多,hCG日内膜厚度更厚,胚胎种植率、临床妊娠率及活产率更高(均P<0.05)。观察组中,移植成功者hCG日内膜厚度较移植失败者厚(P<0.05)。结论反复种植失败患者在降调日加用生长激素预处理后可获得更好的临床效果,妊娠结局有所改善。

Objective To investigate the application efficacy of additional preconditioning with growth hormone on the down-regulation day in patients with repeated implantation failure.Methods A total of 138 infertile patients with repeated implantation failure enrolled were divided into observation group(88 cases)and control group(50 cases).Both groups were treated with long protocol ovulation induction in the mid-luteal phase and in vitro fertilization and embryo transfer(IVF-ET),and the observation group was administered additional growth hormone on the day of down-regulation.IVF-ET related clinical data and pregnancy outcome were compared between the observation group and the control group,and the IVF-ET related clinical data of this cycle and previous cycle in the observation group were observed.Besides,a comparison about IVF-ET related clinical data was conducted between patients with successful and unsuccessful embryo transfer in the observation group.Results Compared with the previous cycle,the observation group yielded higher gonadotropic hormone(GnH)initiation dose and estradiol level on the day of human chorionic gonadotropin(hCG),more oosperms containing two pronucleus,more high-quality embryos,and thicker endometrium on the hCG day in this cycle(all P<0.05).By comparison with the control group,the observation group obtained more follicles≥15 mm on the hCG day and high-quality embryos,thicker endometrium on the hCG day,and higher embryo implantation rate,clinical pregnancy rate and live birth rate(all P<0.05).In the observation group,patients with successful embryo transfer had thicker endometrium on the hCG day than those failing in embryo transfer(P<0.05).Conclusion For patients with repeated implantation failure,additional preconditioning with growth hormone on the day of down-regulation can obtain better clinical effect and improved pregnancy outcome.