降调节联合激素替代冻融胚胎移植周期中不同内膜转化时间对反复种植失败患者临床结局的影响  

Pregnancy outcome of frozen-thawed embryo transfers in repeated implantation failure patients at different transplanting time

作　　者：杨柳[1] 赵翠[1] 张祥[1] 张瑞[1] 岳丰[1] 刘琳[1] 张学红[1] 李丽斐[1] 

机构地区：[1]兰州大学第一医院生殖医学专科医院,兰州730000

出　　处：《生殖与避孕》2016年第11期892-896,922,共6页Reproduction and Contraception

基　　金：中央高校基本科研业务费专项资金面上项目(lzujbky-2013-155);甘肃省科技重大专项(092NKDA009)

摘　　要：目的:探讨反复种植失败(RIF)患者冻融胚胎移植(FET)周期移植时机的选择及对临床结局的影响。方法:选择采用Gn RH-a降调节激素替代方案准备子宫内膜进行FET的RIF患者106例,随机分为A组(常规法)53个周期,即孕酮作用内膜3 d后移植第3日胚胎;B组(改良法)53个周期,即延迟内膜扳机和黄体支持用药,比较组间血清性激素水平、临床妊娠率、早期流产率等相关指标。结果:患者的基本情况组间具有可比性(P>0.05);移植日雌二醇(E_2)、孕酮(P)、E_2/P、临床妊娠率组间均有统计学差异(P<0.05);移植前1日血清P水平组间差异有统计学意义(P<0.05)。结论:对于RIF患者,在降调节联合激素替代-FET周期中,延长雌、孕激素用药时间可刺激内膜达到理想状态,进而获得满意的妊娠结局。Objective： To investigate the pregnancy outcome of frozen-thawed embryo transfers （FET） in repeated implantation failure （RIF） patients at different transplanting time. Methods： Totally 106 FET cycles using artificial cycle to prepare endometrium were collected. These cycles were randomly divided into 2 groups： group A [n=53, transfer day 3 embryo after 3 d progesterone （P） preparation in endometrium], group B （n=53, transfer day 3 embryo after 4 d or 5 d P preparation in endometrium）. The serum hormone and rates of clinical pregnancy, ectopic pregnancy, multiple pregnancy, and the first trimester abortion were compared between the two groups. Results： The basic information of the two groups was comparable （P〉0.05）. There were significant differences in estradiol （E2） level on transplanting day, serum P level on transplanting day, ratio of E2/P on transplanting day and clinical pregnancy rate （P〈0.05）. There were significant differences between pregnancy outcome and P level on the day before transplanting day. Conclusion： The successful implantation of embryo depends on seizing the right time of implantation window in FET. The results show that, it is very convenient to clinical and laboratory work arrangements that moving implantation window backward in time when choosing artificial cycle to prepare endometrium in FET.

关 键 词：冻融胚胎移植(FET) 种植窗 子宫内膜容受性 反复种植失败(RIF) 

分 类 号：R714.8[医药卫生—妇产科学]