富血小板血浆与粒细胞集落刺激因子宫腔灌注治疗薄型子宫内膜对患者子宫螺旋动脉血流及IVF-ET结局影响

Influence of intrauterine perfusion of platelet rich plasma and granulocyte colony stimulating factor for treating patients with thin endometrium on their uterine spiral artery flow and outcomes of in vitro fertilization embryo transfer

目的:分析富血小板血浆(PRP)与粒细胞集落刺激因子(G-CSF)宫腔灌注对行体外受精-胚胎移植(IVF-ET)的薄型子宫内膜患者子宫螺旋动脉血流频谱影响。方法:回顾性收集2019年1月-2022年1月医院收治的行IVF-ET的薄型子宫内膜患者147例,根据治疗方法不同分为PRP组(n=72)和G-CSF组(n=75),分别予以宫腔灌注PRP或G-CSF治疗,比较两组治疗前后子宫螺旋动脉血流频谱、子宫内膜厚度、子宫内膜形态分型和血流分型变化情况,统计两组临床妊娠率、早期流产率、胚胎种植率、移植胚胎个数以及优质胚胎个数。结果:治疗后,两组收缩期峰值流速(PSV)、舒张期峰值流速(EDV)、收缩期峰值流速/舒张期峰值流速(S/D)、阻力指数(RI)以及搏动指数(PI)均低于治疗前,子宫内膜厚度均大于治疗前,子宫内膜形态A型、B型占比升高,C型占比降低(P<0.05),子宫内膜血流分型Ⅰ型占比降低,Ⅱ型、Ⅲ型占比升高(均P<0.05),但两组比较未见差异(P>0.05);两组IVF-ET临床妊娠率、早期流产率、胚胎种植率、移植胚胎个数以及优质胚胎个数比较无差异(P>0.05)。结论:PRP与G-CSF宫腔灌注均可改善薄型子宫内膜患者子宫螺旋动脉血流频谱,促进子宫内膜生长,疗效相当且IVF-ET指标未见差异。

Objective:To analyze the influence of intrauterine perfusion of platelet rich plasma(PRP)and granulocyte colony stimulating factor(G-CSF)for treating patients with thin endometrium on their uterine spiral artery flow and outcomes of in vitro fertilization embryo transfer(IVF-ET).Methods:147patients with thin endometrium who had undergone IVF-ET between January 2019and January 2022were collected retrospectively.These patients were divided into two groups according to different treatment methods.72patients in group A were treated with PRP intrauterine perfusion,and 75patients in group B were treated with G-CSF intrauterine perfusion.The uterine spiral artery flow spectrum,the endometrial thickness,the endometrial morphology classification,and the change of blood flow classification before and after treatment of the patients were compared between the two groups.The clinical pregnancy rate,the early abortion rate,the embryo implantation rate,the number of transferred embryos,and the number of highquality embryos of the patients in the two groups were analyzed statistically.Results:The values of peak systolic velocity(PSV),the peak diastolic velocity(EDV),the peak systolic velocity/peak diastolic velocity(S/D),the resistance index(RI),and the pulse index(PI)of the patients in the two groups after treatment had decreased significantly.The thickness of endometrium of the patients in the two groups after treatment had increased significantly.The proportions of type A and type B of endometrial morphology of the patients in the two groups after treatment had increased significantly,and the proportion of type C of the endometrial morphology of the patients in the two groups after treatment had decreased significantly(P<0.05).The proportion of endometrial blood flow typeⅠof the patients in the two groups after treatment had decreased significantly,and the proportions of endometrial blood flow typeⅡandⅢof the patients in the two groups after treatment had increased significantly(all P<0.05).There were no significant differences in the values of PSV,EDV,S/D,RI,and PI,the thickness of endometrium,the proportions of type A,type B,and of type C,and the proportions of endometrial blood flow typeⅠ,typeⅡ,andⅢof endometrial morphology of the patients between the two groups(P>0.05).There were no significant differences in the rates of clinical pregnancy,the early abortion,the rate of embryo implantation,the embryo transfer number,and the number of the high?quality embryo of the patients2ᦆafter IVF-ET between the two groups(P>0.05).Conclusion:Both intrauterine perfusion of PRP and G-CSF for treating the patients with thin endometrium after IVF-ET can improve their blood flow spectrum of uterine spiral artery and promote their endometrial growth,and both of which have the equivalent efficacy and have no different in the outcome indicators of the patients after IVF-ET.