宫腔粘连术后影响FET成功率的临床因素探讨  

Influencing factors of FET success rate after receiving surgery for intrauterine adhesion

作　　者：季晓媛[1] 赵纯[1] 李秀玲[1] 王培[1] 张军强[1] 武恂[1] 曹善仁[1] 李欣[1] 凌秀凤[1] 

机构地区：[1]南京医科大学附属南京妇幼保健院,江苏南京210004

出　　处：《中国妇幼健康研究》2016年第4期493-496,共4页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目(812707010;81471457)

摘　　要：目的探讨宫腔粘连术后影响辅助生殖患者冻融胚胎移植(FET)临床妊娠率的临床因素。方法回顾性分析2011年3月至2015年6月于南京医科大学附属南京妇幼保健院生殖中心因宫腔粘连行宫腔镜下粘连电切或分离术,择期行冻融胚胎移植130个周期辅助生殖患者的病历资料,根据结局分为妊娠组(G1=46例)及非妊娠组(G2=84例),比较两组的一般情况、术后移植间隔时间、移植胚胎数、优质胚胎数及转化日子宫内膜厚度进一步比较妊娠组(Gl=42例)及非妊娠组(G2=80例)口服雌激素剂量及用药天数的差异此外分析不同用药类型(补佳乐组N1=80例,芬吗通组N2=42例)、不同优胚数目移植组临床妊娠率的差异,以期进一步指导临床治疗。结果 G1组与G2组的一般情况、术后移植间隔时间、移植胚胎数差异均未见统计学意义(均P>0.05)。GI组移植优质胚胎数(1.83±0.570枚)多于G2组(1.30±0.847枚)(t=4.231,P<0.05);移植2枚优质胚胎组临床妊娠率分别高于0枚、1枚优质胚胎组(X^2=11.289,P=0.001;X^2=6.605,P=0.013)。G1组转化日子宫内膜厚度(7.76±1.214mm)高于G2组(6.75±1.131 mm),差异有统计学意义(t=4.725,P<0.05)。G2组口服雌激素剂量高于G1组(t=-2.675,P<0.05),用药天数相近(P>0.05),N1组不孕年限长于N2组(t=2.516,P<0.05),余项差异均无统计学意义(均P>0.05)。结论对于宫腔粘连术后行冻融胚胎移植的患者,转化日子宫内膜厚度及移植优质胚胎数是影响其妊娠结局的重要因素,移植2枚优质胚胎能获得相对更高的临床妊娠率。Objective To investigate the clinical factors that affect the pregnancy rate of frozen-thawed embryo transfer（FET） for patients who receiving surgery for intrauterine adhesion （IUA）. Methods Retrospective analysis of the medical records of 130 patients in 130 FET cycles were carried out. All those patients received elective FET after undergoing hysteroscopic electric resection or hysteroscopic adhesiolysis at the reproductive center of Nanjing Maternity and Child Health Hospital Affiliated Hospital of Nanjing Medical University during March 2011 to June 2015. In accordance with the outcomes, those patients were divided into pregnant group （G1 = 46） and non- pregnant group （ G2 = 84）. Patients＇ general conditions, interval time between surgery and embryo transplantation, numbers of transplanted embryos, high-quality embryosand endometrial thickness on the day of transformation were compared between two groups. Further comparisons were conducted to compare the differences in dosage and duration of oral estrogen between the pregnant group （G1 = 46） and non-pregnant group （G2 = 80 ）. In addition, differences in clinical pregnancy rate among patients who received different types of medication （Progynova group N1 = 80, Femonston group N2 = 42） and different numbers of high-quality embryo transplantations were analyzed so as to further guide clinical treatments. Results There were no statistically significant differences in patients＇ general conditions, interval time between surgery and embryo transplantation and numbers of transplanted embryos between G1 group and G2 group （ all P 〉 0. 05 ）. G1 group （ 1.83± 0. 570） outnumbered G2 group （ 1.30 ± 0. 847 ） in transplanted high-quality embryos （ t = 4. 231, P 〈 0.05 ）. As for patients who received two transplanted high-quality embryos, they had higher pregnancy rates than those who didn＇ t receive any or only one high-quality embryo （X2 =11.289,P=0.001;X2 = 6.605,P =0.013）. G1 group （7.76± 1.214ram） exceeded

关 键 词：宫腔粘连 冻融胚胎移植 子宫内膜厚度 优质胚胎 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]