重组人生长激素在薄型子宫内膜患者冻融胚胎移植中的应用

Application of Recombinant Human Growth Hormone in Patients with Thin Endometrium Undergoing Frozen-thawed Embryo Transfer

目的:研究重组人生长激素(rhGH)治疗薄型子宫内膜患者冻融胚胎移植(FET)的应用价值。方法:收集2018年1月至2020年12月在广西医科大学第三附属医院生殖医疗中心的薄型子宫内膜患者129例,采用激素替代周期进行FET,根据开始进行激素替代治疗(HRT)的时间分为3组:宫腔灌注组(HRT+宫腔灌注rhGH,44例)、皮下注射组(HRT+皮下注射rhGH,42例)和对照组(单纯HRT,43例)。比较3组的一般情况、移植胚胎情况、治疗前后子宫内膜参数及妊娠结局。结果:3组患者的一般情况及治疗前子宫内膜厚度、类型差异无统计学意义(P>0.05)。宫腔灌注组、皮下注射组治疗后的子宫内膜厚度、厚度增幅比对照组高,差异有统计学意义(P<0.05)。宫腔灌注组、皮下注射组治疗后的子宫内膜厚度均较治疗前显著提高,差异有统计学意义(P<0.05)。3组治疗后的子宫内膜类型以及妊娠结局差异无统计学意义(P>0.05)。结论:激素替代治疗联合宫腔灌注或皮下注射rhGH均能显著增加薄型子宫内膜患者的子宫内膜厚度,对妊娠结局无明显影响。

Objective:To evaluate the application value of recombinant human growth hormone(rhGH)in the patients with thin endometrium in frozen-thawed embryo transfer(FET)cycle.Methods:A prospective study was conducted among 129 patients with thin endometrium underwent FET between January 2018 and December 2020 in the Reproductive Medical Center of The Third Affiliated Hospital of Guangxi Medical University.All patients received hormone-replacement therapy(HRT)for endometrial preparation.They were divided into three groups according to the time of starting HRT:intrauterine perfusion group(HRT+intrauterine perfusion of rhGH,44 cases),subcutaneous injection group(HRT+subcutaneous injection of rhGH,42 cases)and control group(only HRT,43 cases).The general conditions,transferred embryos,endometrial parameters before and after treatment and pregnancy outcomes of the three groups were compared.Results:There was no significant difference in general conditions,endometrial thickness and type before treatment of the three groups(P>0.05).The endometrial thickness and thickness increase were higher in intrauterine perfusion group and subcutaneous injection group than in control group,the difference was statistically significant(P<0.05).In the intrauterine perfusion group and subcutaneous injection group,endometrial thickness were significantly increased after treatment compared with those before treatment(P<0.05).There was no significant difference in endometrial type and pregnancy outcome among the three groups(P>0.05).Conclusions:Hormone replacement therapy combined with intrauterine perfusion or subcutaneous injection of rhGH can significantly increase the endometrial thickness of patients with thin endometrium,and has no significant effect on pregnancy outcome.