子宫内膜不同刺激方式对冻融胚胎移植患者妊娠结局的影响

Effects of different stimulation methods of endometrium on pregnancy outcome of frozen-thawed embryo transfer patients

目的探究冻融胚胎移植(FET)前患者行子宫内膜机械刺激、宫腔灌注人绒毛膜促性腺激素(hCG)、宫腔灌注重组人生长激素(GH)治疗对妊娠结局的影响。方法对2018年1月—2019年8月在淄博市妇幼保健院生殖医学中心着床失败再次行FET治疗的患者共376个周期进行回顾性研究,分为A组(子宫内膜机械刺激36个周期)、B组(宫腔灌注hCG 158个周期)、C组(宫腔灌注GH 90个周期)、D组(未进行宫腔灌注治疗92个周期),比较各组患者黄体酮转化日子宫内膜厚度、着床率、临床妊娠率、早期流产率、活产率。结果A组、B组、C组、D组黄体酮转化日子宫内膜厚度分别为(9.77±1.20)mm、(10.08±1.51)mm、(9.35±1.54)mm、(9.30±1.25)mm,临床妊娠率分别为52.78%、55.70%、52.22%、36.96%,4组黄体酮转化日子宫内膜厚度、临床妊娠率比较差异均有统计学意义(F=19.012,P<0.05;χ^(2)=8.614,P<0.05)。结论着床失败的患者在FET前行子宫内膜机械刺激、宫腔灌注hCG、宫腔灌注GH可以改善子宫内膜厚度,有助于提高临床妊娠率。

Objective To explore the effects of mechanical stimulation of endometrium,intrauterine infusion of human chorionic gona⁃dotropin(hCG),and intrauterine infusion of recombinant human growth hormone(GH)on pregnancy outcome of frozen-thawed embryo transfer(FET)patients.Methods The patients(376 cycles)treated with FET after failing in implantation in Reproductive Medicine Center of Zibo Maternal and Child Health Hospital from January 2018 to August 2019 were researched retrospectively,then they were divided into group A(mechanical stimulation of endometrium,36 cycles),group B(intrauterine infusion of hCG,158 cycles),group C(intrauterine infusion of GH,90 cycles),and group D(without uterine cavity treatment,92 cycles).Endometrial thicknesses,implantation rates,clini⁃cal pregnancy rates,early abortion rates and live births rates on the day of progesterone administration in the four groups were com⁃pared.Results Endometrial thicknesses on the day of progesterone administration in group A,group B,group C,and group D were(9.77±1.20)mm,(10.08±1.51)mm,(9.35±1.54)mm,and(9.30±1.25)mm,respectively;the clinical pregnancy rates in group A,group B,group C,and group D were 52.78%,55.70%,52.22%,and 36.96%,respectively.There were statistically significant differences in endometrial thickness on the day of progesterone administration and clinical pregnancy rate(F=19.012,P<0.05;χ^(2)=8.614,P<0.05).Conclusion For the patients with implantation failure,mechanical stimulation of endometrium,intrauterine infusion of hCG,and intrauter⁃ine infusion of GH before FET can improve endometrial thickness and contribute to the increase of clinical pregnancy rate.