PRP宫内灌注联合雌二醇片/雌二醇地屈孕酮片在薄型子宫内膜不孕FET中的应用

Application of intrauterine platelet-rich plasma infusion combined with estradiol tablets/estradiol dydrogesterone tablets in frozen-thawed embryo tranfer of thin endometrial infertility

目的分析薄型子宫内膜不孕冻融胚胎移植(FET)患者应用富血小板血浆(PRP)宫内灌注联合雌二醇片/雌二醇地屈孕酮片治疗的效果。方法将2020年1月至2022年12月于唐山市中医医院妇产科就诊的135例薄型子宫内膜不孕患者采用随机数字表法分为对照组(n=67)与治疗组(n=68)。两组均行FET治疗,对照组采用雌二醇片/雌二醇地屈孕酮片进行子宫内膜准备,治疗组采用PRP宫内灌注联合雌二醇片/雌二醇地屈孕酮片进行子宫内膜准备。比较两组不同时点血清生长因子、子宫内膜容受性情况,并比较两组妊娠结局。结果与治疗前相比,两组囊胚移植日、移植后1周血清血管内皮生长因子(VEGF)、转化生长因子-β1(TGF-β1)水平均升高,子宫内膜厚度均增加,子宫动脉阻力指数均减小,且治疗组改善更显著(P<0.05);治疗组血清学妊娠率及临床妊娠率均较对照组高,早期流产率较对照组低(P<0.05)。结论薄型子宫内膜不孕患者FET过程中行PRP宫内灌注联合雌二醇片/雌二醇地屈孕酮片治疗有助于提高血清生长因子水平,改善子宫内膜容受性及妊娠结局。

Objective To analyze the efficacy of intrauterine platelet-rich plasma(PRP)infusion combined with estradiol tablets/estradiol dydrogesterone tablets treatment in patients with thin endometrial infertility undergoing frozen-thawed embryo transfer(FET).Methods A total of 135 patients with thin endometrium infertility in Department of Obstetrics and Gynecology,Tangshan Hospital of Traditional Chinese Medicine from January 2020 to December 2022 were randomly divided into a control group(n=67)and a treatment group(n=68)using a random number table method.Both groups received FET treatment,and the control group received estradiol tablets/estradiol dydrogesterone tablets for endometrial preparation,while the treatment group received intrauterine PRP infusion combined with estradiol tablets/estradiol dydrogesterone tablets for endometrial preparation.The status of serum growth factors and endometrial receptivity at different time points were compared between the two groups,and the pregnancy outcomes of the two groups were also compared.Results Compared with before treatment,the levels of serum vascular endothelial growth factor(VEGF)and transforming growth factor-β1(TGF-β1)in the two groups were increased on the day of blastocyst transplantation and 1 week after transplantation.The endometrial thickness was increased,and the uterine artery resistance index was decreased in both groups,and the improvement in the treatment group was more significant(P<0.05).The serological pregnancy rate and clinical pregnancy rate in the treatment group were higher than those in the control group,and the early abortion rate was lower than that in the control group(P<0.05).Conclusions Intrauterine PRP infusion combined with estradiol tablets/estradiol dydrogesterone tablets treatment during FET in patients with thin endometrium infertility can help increase serum growth factor levels,and improve endometrial receptivity and pregnancy outcomes.