三种内膜准备方案在不育症患者冻融胚胎移植周期中的临床应用  

Clinical application of three protocols of endometrial preparation in frozen-thawed embryo transfer cycles

作　　者：杜彦[1] 廖月婵[1] 吴日然[1] 叶云[1] 林秀峰[1] 杜静[1] 

机构地区：[1]广东省中山市博爱医院生殖中心,中山市528403

出　　处：《生殖医学杂志》2013年第7期495-499,共5页Journal of Reproductive Medicine

摘　　要：目的探讨三种内膜准备方案在冻融胚胎移植(FET)周期中的临床应用效果。方法选取需行FET的患者208例,随机分为17β雌二醇组(82例),戊酸雌二醇组(70例)和自然周期组(56例),观察对比三组患者的周期取消率、临床妊娠率、早期流产率和胚胎种植率。结果 17β雌二醇组,戊酸雌二醇组和自然周期组周期取消率分别为7.6%、11.4%、16.7%,临床妊娠率分别为34.3%、29.0%、35.6%,早期流产率分别为12.0%、11.1%、12.5%,胚胎种植率分别为1 6.3%、14.8%、16.4%。三组临床妊娠率、早期流产率和胚胎种植率相比差异无统计学意义(P>0.05),自然周期组周期取消率显著升高,差异有统计学意义(P<0.05)。结论用17β雌二醇行雌、孕激素序贯疗法模拟人工周期准备内膜,可以降低解冻移植周期的周期取消率,而且临床妊娠率和早期流产率与戊酸雌二醇人工周期法和自然周期法相比无统计学差异,说明17β雌二醇内膜准备有效果,在今后的临床实际工作中可以使用,尤其是无排卵或稀发排卵的患者。Objective： To explore the clinical effect of application of 17β-estradiol in the endometrial preparation in the frozen-thawed embryo transfer（FET）cycle. Methods： Two hundred and eight female infertility patients in FET cycles were randomly divided into three groups： 17β-estradiol group （82 patients）, estradiol valerate group （70 patients）, and natural cycle group（56 patients）. The cycle cancellation rate,implantation rate, early abortion rate,and pregnancy rate were compared among the three groups. Results： The cycle cancellation rate was 7.6%,11.4% and 16.7%,pregnancy rate 34.3% ,29.0% and 35.6%,early abortion rate 12.0%,11.1% and 12.5% and implantation rate 16.3%,14.8% and 16.4% respectively in the three groups. There were no statistical differences in early abortion rate, pregnancy rate or implantation rate among the three groups（P〉0.05）. However, there was a significantly higher cycle cancellation rate in natural cycle group（P〈0.05）. Conclusions： When 17β-estradiol is used for preparing the endometrium in frozen-thawed transfer cycles, the cycle cancellation rate can be reduced when compared with that of the natural cycle group, while the pregnancy rate and early abortion rate were not significantly different from those of estradiol valerate cycle and natural cycle groups. It indicates that application of 17β-estradiol for endometrial preparation is effective and it can be used in the clinical practice, especially to those patients with no or less ovulation.

关 键 词：17Β雌二醇 冷冻胚胎移植 内膜准备 周期取消率 妊娠率 

分 类 号：R4[医药卫生—临床医学]