醋酸曲普瑞林对体外受精-胚胎移植激素替代周期治疗患者子宫内膜及性激素的影响

Effect of triptorelin acetate combined with hormone replace treatment on endometrium and sex hormone level in patients with IVF-ET

目的探讨醋酸曲普瑞林对体外受精-胚胎移植(IVF-ET)激素替代周期治疗患者子宫内膜及性激素的影响。方法选取2015年1月—2017年1月接受IVF-ET治疗的患者100例,根据随机数字表法分为对照组与观察组,各50例。对照组单纯采取激素替代周期,观察组在激素替代周期治疗基础上使用醋酸曲普瑞林,对比两组治疗前及治疗后血清性激素水平,比较两组子宫内膜厚度、内膜转换时间及妊娠结局。结果治疗后,两组子宫内膜厚度均增厚(P<0.05);观察组子宫内膜厚度厚于对照组,内膜转换时间短于对照组,差异有统计学意义(P<0.05)。两组患者基础血清性激素水平比较,差异无统计学意义;治疗后,两组促黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)水平降低,孕酮(P)、泌乳素(PRL)水平升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,两组患者LH、FSH、PRL、P、T水平比较,差异无统计学意义;观察组E2水平低于对照组,差异有统计学意义(P<0.05)。两组患者胚胎种植率、早期流产率比较,差异无统计学意义;观察组临床妊娠率高于对照组,差异有统计学意义(P<0.05)。结论醋酸曲普瑞林联合激素替代周期在胚胎着床及临床妊娠方面较单纯激素替代周期方案效果更理想,患者血清雌二醇水平明显改善,子宫内膜厚度增加,联合方案并不会增高患者早期流产率。

Objective To investigate the effect of triptorelin acetate combined with hormone replace treatment on endometrium and sex hormone level in patients with in vitro fertilization and embryo transfer(IVF-ET),and to provide reasonable reference for future treatment of IVF-ET.Methods 100 patients with IVF-ET treatment in our hospital from January 2015 to January 2017 were selected,and they were divided into control group and observation group by random number table,with 50 cases in each group.Control group was purely given hormone replace treatment,while observation group was treated with triptorelin acetate based on control group.The basic serum sex hormone and falling 14 d serum sex hormone levels were compared between the two groups.The endometrial thickness and endometrial conversion time,pregnancy outcome of two groups were compared.Results The endometrial thickness of observation group was thicker than that of control group,and the endometrial conversion time was shorter than control group(P<0.05).There was no statistical difference in the basic serum sex hormone levels between the two groups.In the falling of14 d,there was no statistical difference in the levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),prolaction(PRL),progesterone(P),testosterone(T)between the two groups.The levels of estradiol(E2)in observation group was lower than that in control group(P<0.05).There was no statistical difference in the embryo implantation rate and first trimester abortion rate between the two groups.The clinical pregnancy rate of observation group was higher than that of control group(P<0.05).Conclusion Triptorelin acetate combined with hormone replace treatment is more effective in embryo implantation and clinical pregnancy than pure hormone replace treatment,which can improve estradiol level and increase endometrial thickness.The combined therapy will not increase the first trimester abortion rate,and it has satisfactory safety.