[1]王利群,李萌,汤小晗,等.促性腺激素释放激素类似物在子宫内膜形态不良者冷冻胚胎移植前干预的临床价值[J].中国计划生育和妇产科,2020,(1):42-47.
　WANG Li-qun,LI Meng,TANG Xiao-han,et al.Clinical value of GnRH-a in pre-frozen embryo transfer in patients with endometrial morphology[J].Chinese Journal of Family Planning & Gynecotokology,2020,(1):42-47.
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促性腺激素释放激素类似物在子宫内膜形态不良者冷冻胚胎移植前干预的临床价值
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2020年1期
页码:
42-47
栏目:
论著与临床
出版日期:
2020-01-25

文章信息/Info

Title:
Clinical value of GnRH-a in pre-frozen embryo transfer in patients with endometrial morphology
作者:
王利群; 李萌; 汤小晗; 卢美松*
哈尔滨医科大学附属第一医院妇产科
Author(s):
WANG Li-qun; LI Meng; TANG Xiao-han; LU Mei-song*
Department of Obstetrics and Gynecology,the First Affiliated Clinical College of Harbin Medical University, Harbin Heilongjiang 150001,P.R.China
关键词:
冻融胚胎; 子宫内膜形态不良; 激素替代; 降调节; 内膜准备; 妊娠率
Keywords:
frozen-thaw embryo;  poor endometrial morphology;  hormone replacement;  down regulation;  endometrial preparation;  pregnancy rate
分类号:
R 711.6
摘要:
目的对冻融胚胎移植(frozen-thawed embryo transfer,FET)中内膜形态不良者移植优质胚胎，比较不同的内膜准备方案，探讨长效促性腺激素释放激素类似物(gonadotropin-releasing hormone agonist,GnRH-a)降调节联合激素替代作为内膜准备方案临床应用价值。方法回顾性分析哈尔滨医科大学附属第一医院生殖中心2015年1月至2018年8月收治FET中子宫内膜形态不良的231例患者临床资料，根据不同的内膜准备方案将其分为激素替代组(hormone replace treatment,HRT)(131例)和降调节联合激素替代组(100例)。分析两组患者的一般情况、临床指标及妊娠结局。结果两组一般情况、基础内分泌水平、移植胚胎发育情况比较，差异无统计学意义(P＞005)；两组移植日内膜厚度差异无统计学意义(P＞005)；黄体酮日和移植日内膜类型降调节联合激素替代组优于激素替代组(P＜005)；降调节联合激素替代组生化妊娠率(16例，16 %)高于激素替代组(4例，3 %)，差异有统计学意义(P＜005)；降调节联合激素替代组临床妊娠率(59例，59 %)高于激素替代组(68例，519 %)，但差异无统计学意义(P＞005)；两组胚胎种植率、多胎妊娠率、异位妊娠率、早期流产率比较，差异无统计学意义(P＞005)。Logistic分析结果显示对临床妊娠结局指标有意义的变量为年龄和体质量指数，β值估计分别为-0129、-0123，说明年龄越小，体质量指数越低，临床妊娠率越高。结论对于子宫内膜形态不良者，降调节联合激素替代方案在改善子宫内膜形态及妊娠结局方面具有一定的潜在作用，是内膜形态不良者可行的内膜准备方案。
Abstract:
ObjectiveHigh-quality embryos were transferred to those with poor endometrial morphology during frozen-thawed embryo transfer (FET), and were to explore the clinical application value of long-acting gonadotropin-releasing hormone agonist (GnRH-a) down-regulation combined with hormone replacement as an endometrial preparation protocol. MethodsThe clinical data of 231 patients with endometrial malformation in FET from January 2015 to August 2018 were retrospectively analyzed in the Reproductive Center of the First Clinical Hospital Affiliated to Harbin Medical University.According to different endometrial preparation schemes, they were dirided into hormone replacement treatment (HRT) group (n=131) and down-regulation combined hormone replacement treatment group (n=100). The general conditions, clinical indicators and pregnancy outcomes of the two groups of patients were analyzed. ResultsThere were no significant differences in general conditions, basal endocrine levels, and embryo development in the two groups (P>005). There was no significant difference in endometrial thickness between the two groups on transplant day (P>005). Progesterone and transplantation days Endometrial type of down-regulation combined with hormone replacement group was better than hormone replacement group (P<005); biochemical pregnancy rate (16 cases, 16 %) of down-regulation combined hormone replacement group was higher than that of hormone replacement group (4 cases, 3 %), the difference was statistically significant (P<005); the clinical pregnancy rate (59 cases, 59 %) of the down-regulation combined hormone replacement group was higher than that of the hormone replacement group (68 cases, 519 %), but the difference was not statistically significant (P>005); There were no significant differences in embryo implantation rate, multiple pregnancy rate, ectopic pregnancy rate, and early abortion rate between the two groups (P> 005). Logistic analysis showed that the variables that were significant for the pregnancy outcome indicators were age and body mass index. The β values were estimated to be -0129 and -0123, indicating that the younger the age, the lower the body mass index and the higher the clinical pregnancy rate. ConclusionFor patients with poor endometrial morphology, down-regulation combined with hormone replacement has a potential role in improving endometrial morphology and pregnancy outcomes. It is a feasible endometrial preparation program for patients with poor endometrial morphology.

参考文献/References:

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更新日期/Last Update: 2020-01-25