月经期子宫内膜病理分型对体外受精失败患者复融周期成功率的影响  

Influence of menstrual endometrial pathological features on the success rate of freezing-thawed cycles in patients undergoing IVF failure

作　　者：梁琳琳[1] 何巧花[1] 李杭生[1] 张翠莲[1] 路锦[1] 

机构地区：[1]河南省人民医院生殖中心,河南郑州450003

出　　处：《河南大学学报（医学版）》2014年第3期190-194,共5页Journal of Henan University:Medical Science

基　　金：河南省医学科技攻关项目(200804078)

摘　　要：目的探讨体外受—胚胎移植/卵胞浆内单精子注射(IVF-ET/ICSI)周期失败后,月经期子宫内膜病理分型对复融周期成功率的影响。方法选择生殖中心2009年1月至2010年1月行IVF-ET/ICSI周期失败患者,拟复融周期月经来潮24h内行内膜搔刮术,将刮出物中少量子宫内膜组织送病检;按子宫内膜病理分型,分为分泌期组、增生期组、月经期组;按照3组选用人工周期(HRT)或监测排卵方案进行复融移植,又分为人工周期方案、监测排卵方案,比较各组复融周期胚胎种植率、妊娠率及流产率。结果共获病理报告317例,其中分泌期组68例,增生期组123例、月经期组126例。人工周期方案与监测排卵周期方案中,增生期组的胚胎着床率分别为33.33%、31.93%、临床妊娠率分别为52.46%、54.84%,均高于分泌期组的胚胎着床率(25.00%,29.03%)、临床妊娠率(48.39%,45.95%)和月经期组的胚胎着床率(24.75%,28.81%)、临床妊娠率(48.21%,50.00%),但差异无统计学意义(P>0.05)。2种方案中,月经期组早期流产率分别为12.5%、12.86%,高于增生期组(9.84%、6.45%)、分泌期组(9.68%、8.11%),但差异亦无统计学意义(P>0.05)。结论移植前增生期子宫内膜的胚胎着床率、妊娠率较高,而月经期子宫内膜的流产率较高,但无明显临床意义。Objective To determine the effect of menstrual endometrial pathological features on endometrial reception,and pregnancy rates in patients undergoing freezing thawed cycles.Methods The study was carried out in women undergoing IVF/ICSI（in vitro fertilization cycles/intracytoplasmic sperm injection）failure from January2009 to January 2010 in reproductive center.Endometrial scraping technique was done within 24 hours of menstrual period.The scrapings containing a small amount of endometrial organization were sent to the pathological examination.According to endometrial pathology type,the patients were divided into the secretory phase group,proliferative phase group,menstrual phase group.In accordance with selected thawed cycles in frozen embryo transfer cycles artificial cycle（HRT）or monitoring ovulation cycle,each group was divided into artificial cycle,ovulation monitoring cycle.To compared implantation rate,pregnancy rate and abortion rate in three groups.Results 317 pathology reports were got.The secretory phase group were 68.The proliferative phase group was 123.The menstrual phase group was 126.In artificial cycle（HRT）and monitoring ovulation cycle,embryonic implantationrate were 33.33%,31.93%,pregnancy rate were 52.46%,54.84%in proliferative phase,which were higher than embryonic implantation rate（25.00%;29.03%）,pregnancy rate（48.39%;45.95%）in secretory phase group（27.19%;47.05%）and embryonic implantation rate（24.75%;28.81%）,pregnancy rate（48.21%;50.00%）in menstrual phase group.But there was no statistically significant difference（P〉0.05）.In two thawed cycles,abortion rate in menstrual phase group were 12.5%,12.86%,which were higher than that in proliferative phase group（9.84%;6.45%）and that in secretory phase group（9.68%;8.11%）,but the difference is not statistically significant（P〉0.05）.Conclusion Embryo implantation rate,pregnancy rate were higher in proliferative endometrium,while the abortion rate was higher in menstrual endometrium.

关 键 词：子宫内膜 搔刮术 胚胎着床率 妊娠率 

分 类 号：R321.2[医药卫生—人体解剖和组织胚胎学]