宫腔灌注粒细胞刺激因子不同次数对反复种植失败患者冻融胚胎移植临床结局的影响

Effect of different times of intrauterine G-CSF infusion on clinical outcome of frozen-thawed embryo transfer in patients with recurrent implantation failures

目的探讨宫腔灌注粒细胞刺激因子(G-CSF)次数对2次及以上反复种植失败(RIF)患者临床结局的影响。方法回顾性分析2017年9月至2020年4月在该院行冻融胚胎移植治疗的不明原因2次及以上RIF患者的369个周期资料,按150μg G-CSF宫腔灌注次数分A组(宫腔灌注0次,278例)、B组(宫腔灌注1次,51例)和C组(宫腔灌注2次,40例)。比较3组患者临床妊娠率等。结果3组患者年龄、不孕年限、基础卵泡刺激素水平、移植胚胎数、早期流产率、活产率比较,差异均无统计学意义(P>0.05);A组患者移植日内膜厚度[(9.35±1.39)mm]与B、C组[(9.62±1.89)、(8.45±1.38)mm]比较,差异均有统计学意义(P<0.05);且A、B、C组患者β-人绒毛膜促性腺激素(hCG)阳性率(分别为58.4%、70.6%、77.5%),临床妊娠率(分别为50.4%、64.7%、68.4%)均依次递增,差异均有统计学意义(P<0.05)。结论不明原因2次及以上RIF患者宫腔灌注G-CSF可增加β-hCG阳性率和临床妊娠率,且宫腔灌注2次效果优于灌注1次者。

Objective To investigate the effect of the times of intrauterine G-CSF infusion on the clinical outcome of frozen-thawed embryo transfer in the patients with recurrent implantation failures(RIF)≥2 times.Methods The 369 cycles data in the patients with RIF≥2 times due to unknown reasons in this hospital from September 2017 to April 2020 were retrospectively analyzed.According to the times of intrauterine G-CSF 150μg perfusion,the patients were divided into the group A(0 time of intrauterine perfusion,278 cases),group B(once of intrauterine G-CSF perfusion,51 cases)and group C(twice of intrauterine G-CSF perfusion,40 cases).The clinical pregnancy rates were compared among 3 groups.Results There were no statistically significant differences in the age,infertility years,basic FSH level,number of transplant embryos,early abortion rate and live birth rate among 3 groups(P>0.05).The endometrium thickness on the implantation day had statistical difference among the group A,B and C[(9.35±1.39)mm,(9.62±1.89)mm and(8.45±1.38)mm respectively,(P<0.05)];moreover theβ-hCG positive rates in the group A,B and C were 58.4%,70.6%and 77.5%respectively,and the clinical pregnancy rates were 50.4%,64.7%and 68.4%respectively,which were increased in order,and the differences were statistically significant(P<0.05).Conclusion The intrauterine G-CSF infusion in the patients with RIF≥2 times due to unknown reasons may increase theβ-hCG positive rate and clinical pregnancy rates,moreover the effect of twice intrauterine G-CSF perfusion is better than that of once intrauterine G-CSF perfusion.