子宫内膜搔刮术在反复移植失败患者中的临床应用  

Clinical Application of Endometrial Scratching in Patients with Repeated Implantation Failure

作　　者：赵华[1] 郭娜[1] 李豫峰[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院生殖中心,武汉430030

出　　处：《华中科技大学学报（医学版）》2015年第5期578-581,共4页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨子宫内膜搔刮术在反复移植失败(repeated implantation failure,RIF)患者中的临床应用价值。方法选择2013年10月至2014年8月在华中科技大学同济医学院附属同济医院生殖中心就诊,因女方输卵管因素不孕(男方精液正常)行IVF-ET治疗反复移植失败再次进入新的IVF-ET周期的患者,进行前瞻性随机对照研究。按病例编号把纳入标准的189例患者随机分成实验组(n=96)和对照组(n=93),实验组在取卵周期前1个月经周期月经来潮6h内进行内膜搔刮,对照组不行内膜搔刮,比较胚胎移植后两组临床结局。结果两组患者年龄、不孕年限、体重指数、基础血清FSH、LH及P水平、Gn天数、Gn总量、获卵数、胚胎移植数、HCG日血清E2、P水平及HCG日内膜厚度相比较,差异均无统计学意义(均P>0.05),实验组胚胎着床率、临床妊娠率及持续妊娠率均明显高于对照组,差异均有统计学意义(均P<0.01)。结论子宫内膜搔刮术可以改善子宫内膜容受性,提高RIF患者的临床妊娠率。Objective To explore the clinical application of endometrial scratching in patients with repeated implantation failure（RIF）.Methods A total of 189 women with RIF who planned to undergo in vitro fertilization and embryo transfer（IVFET）once again at the Reproductive Medicine Center of Tongji Hospital,Huazhong University of Science and Technology,between October 2013 and August 2014,were prospectively examined.These women were infertile due to tubal factors,with their male partners having normal semen measurements.According to the case numbers,the 189 patients were randomly divided into experimental group（n=96）and control group（n=93）.In the experimental group,endometrial scratching was conducted within 6h of one menstrual cycle one month before oocyte retrieval,while in control group,no endometrial scratching was performed at that time.The outcomes of pregnancy were compared between the two groups after embryo transplantation.Results There was no statistical difference between the two groups in the patient age,infertility duration,body mass index（BMI）,basal levels of follicle-stimulating hormone（FSH）,luteinizing hormone（LH）,and progesterone（P）,gonadotropin-releasing hormone（Gn-RH）injection days and doses,the number of retrieved oocytes,the number of transferred embryos,the endometrial thickness and levels of estradiol（E2）and P on the day of HCG injection（P〈0.05）.The embryo implantation rate,the clinical pregnancy rate and the ongoing pregnancy rate in the experimental group were much higher than those in the control group,with statistically significant difference noted（P〈0.01）.Conclusion The endometrial scratching can improve the endometrial receptivity and enhance the clinical pregnancy rate of RIF patients.

关 键 词：子宫内膜容受性 子宫内膜搔刮术 反复着床失败 体外受精-胚胎移植 

分 类 号：R713.7[医药卫生—妇产科学]