自然周期准备内膜在子宫内膜异位症患者冻融胚胎移植中的结局分析  

Efficacy of natural cycle endometrial preparation for frozen-thawed embryo transfer in patients with endometriosis

作　　者：郭海燕[1] 汪云[1] 陈秋菊[1] 匡延平[1] 

机构地区：[1]上海交通大学医学院附属上海第九人民医院生殖医学中心,上海200011

出　　处：《生殖与避孕》2016年第6期458-463,共6页Reproduction and Contraception

摘　　要：目的:研究以自然周期作为子宫内膜准备方式对子宫内膜异位症(EMS)患者冻融胚胎移植(FET)妊娠结局的影响。方法:回顾性分析EMS患者353个FET周期,按EMS严重程度分组,A组:I^II期,120个周期;B组:III^IV期,233个周期;另将B组中囊肿复发的47个周期设为D组;而将输卵管因素不孕患者的300个FET周期纳入为对照组(C组),比较A、B、C组患者自然周期准备内膜的妊娠结局。结果:A、B、C组患者的种植率、活产率、继续妊娠率、流产率、妊娠期并发症率无统计学差异(P>0.05),且妊娠结局与EMS的分期无关。A、B、C组均没有出生缺陷儿。当高质量的胚胎移植时,卵巢内膜异位囊肿并不影响妊娠结局。B组较C组低出生体质量儿和早产儿的发生率高。结论:EMS患者自然周期准备内膜与输卵管性因素不孕患者有相似的妊娠结局,且与EMS严重程度无关,妊娠结局不受内膜异位囊肿的影响,是经济、高效的内膜准备方法。Objective： To study the efficacy of natural cycle （NC） endometrial preparation for frozen-thawed embryo transfer （FET） in women with endometriosis （EMS）. Methods： A retrospective study was carried out in women with EMS, including 120 cycles with stage I-II EMS （group A）; 233 cycles with stage III-IV EMS （group B）; 300 cycles with tubal factor infertility （group C）. In group B, 42 patients received 47 cycles and had endometrial cyst recurrence （group D） after laparoscopic treatment. All groups were prepared for FET using a NC protocol. Results： The implantation rate （group A： 32.4%, group B： 36.0%, group C： 30.4%, P=0.169）, the pregnancy rate （group A： 43.3%, group B： 50.2%, group C： 45.3%, P=0.381）, and the live-birth rate （group A： 35.83%, group B： 39.91%, group C： 39.0%, P=-0.587） were similar. No differences were observed in ongoing pregnancy rate, miscarriage rate, and pregnancy complication rate, independently from severity of EMS. No congenital birth defects were found. When high-quality embryos were transferred, pregnancy outcomes were not affected by active endometrial cyst. Conclusion： There was no difference in pregnancy outcomes between EMS patients received NC endometrial preparation and patients with tubal infertility, which were not affected by the stage of EMS. The pregnancy outcomes were not affected by active endometrial cyst.

关 键 词：冻融胚胎移植(FET) 自然周期 子宫内膜异位症(EMS) 临床妊娠结局 激素替代 

分 类 号：R711.71[医药卫生—妇产科学] R714.8[医药卫生—临床医学]