仿生电刺激联合人工周期对卵巢储备功能减退患者子宫容受性及血清生长分化因子-9、抑制素B、骨形态发生蛋白-10水平的影响

Effect of bioelectric stimulation combined with artificial cycle on uterine receptivity and serum levels of growth differentiation factor-9,statin B and bone morphogenetic protein-10 in patients with diminished ovarian reserve

目的探讨仿生电刺激联合人工周期对卵巢储备功能减退(DOR)患者子宫容受性及血清生长分化因子-9(GDF-9)、抑制素B(INHB)、骨形态发生蛋白-10(BMP-10)水平的影响。方法选取2019年1月至2022年3月广西壮族自治区妇幼保健院收治的87例DOR患者作为研究对象。采用随机数字表法分为A组、B组、C组,每组29例。A组采用仿生电刺激治疗,B组采用人工周期治疗,C组采用仿生电刺激联合人工周期治疗。比较三组治疗前后子宫容受性,血清GDF-9、INHB、BMP-10水平,子宫内膜血流参数及卵巢体积;随访1年,比较三组的妊娠情况;比较三组治疗期间不良反应发生情况。结果与治疗前比较,治疗后A组、B组、C组初级卵泡数、优势卵泡数、排卵数及血清GDF-9、INHB、BMP-10水平均升高,卵巢体积均增大,且A组、B组、C组呈增高趋势(P<0.05)。与治疗前比较,治疗后A组、B组、C组子宫内膜血流搏动指数(PI)、子宫内膜血流阻力指数(RI)均减小,且A组、B组、C组呈下降趋势(P<0.05)。随访1年,C组妊娠率高于A组、B组(P<0.05)。治疗期间,三组不良反应发生率比较,差异无统计学意义(P>0.05)。结论仿生电刺激联合人工周期可提高DOR患者子宫容受性,改善子宫内膜血流参数及卵巢体积,也可改善血清GDF-9、INHB、BMP-10水平,提高自然妊娠率,且安全性好。

Objective To evaluate the effects of bioelectric stimulation combined with artificial cycle on uterine receptivity and serum levels of growth differentiation factor-9(GDF-9),statin B(INHB)and bone morphogenetic protein-10(BMP-10)in patients with diminished ovarian reserve(DOR).Methods A total of 87 DOR patients admitted to the Guangxi Maternal and Child Health Care Hospital from January 2019 to March 2022 were selected as study objects.They were divided into Group A,Group B and Group C by random number table method,with 29 patients in each group.Group A was treated with bioelectric stimulation,Group B was treated with artificial cycles,and Group C was treated with bioelectric stimulation combined with artificial cycles.The uterine receptivity,serum GDF-9,INHB,BMP-10 levels,endometrial flow parameters,and ovarian volume were compared before and after treatment.After 1-year follow-up,the pregnancy status of the three groups was compared.The occurrence of adverse reactions during treatment was compared between the three groups.Results Compared with those before treatment,the number of primary follicles,dominant follicles,ovulation,the serum levels of GDF-9,INHB,BMP-10,and the ovarian volume all increased in Group A,Group B and Group C after treatment,and showed an increasing trend among Group A,Group B and Group C(P<0.05).Compared with those before treatment,the endometrial flow pulsatility index(PI)and endometrial flow resistance index(RI)all decreased in Group A,Group B and Group C,and showed a decreasing trend among Group A,Group B and Group C(P<0.05).After 1-year follow-up,the pregnancy rate in Group C was higher than that in Group A and Group B(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse effects among Group A,Group B and Group C.(P>0.05).Conclusions Bioelectric stimulation combined with artificial cycle can improve uterine receptivity in DOR patients,improve endometrial blood flow parameters and ovarian volume,improve serum levels of GDF-9,INHB and BMP-10,and improve natural pregnancy rate with good safety.