生长激素宫腔灌注在薄型子宫内膜冻融胚胎移植中的疗效观察  

Clinical observation of growth hormone intrauterine perfusion combined with replacement cycle in the treatment of thin endometrium

作　　者：禹虹[1] 唐慧珍[1] 柳朝华[1] 陈辉莲[1] 邓朝晖[1] 唐亭亭[1] 吴晓丽[1] 

机构地区：[1]湖南省妇幼保健院生殖中心,长沙410008

出　　处：《中国医师杂志》2017年第3期371-375,共5页Journal of Chinese Physician

基　　金：湖南省卫计委科研基金（B2013-084）

摘　　要：目的探讨生长激素（GH）宫腔灌注联合替代周期在薄型子宫内膜患者冻融胚胎移植中的临床疗效。方法回顾性分析2014年6月至2015年9月在湖南省妇幼保健院生殖中心行替代周期冻胚移植的患者共88个周期，其中激素替代周期组（A组）63个，GH宫腔灌注联合替代周期薄型子宫内膜组（B组）25个。比较分析两组患者子宫内膜厚度、临床妊娠及胚胎种植情况。结果B组25例患者既往移植日子宫内膜厚度〈7 mm，本周期应用GH灌注联合替代周期治疗后，22例患者移植日子宫内膜厚度≥7 mm。两组患者年龄、不孕年限、移植胚胎数及移植优胚数差异均无统计学意义（P〉0.05）。A组患者移植日子宫内膜厚度[（9.28±1.64）mm]明显高于B组子宫内膜厚度[（7.9±0.86）mm]，差异有统计学意义（P〈0.05）；但A组与B组临床妊娠率（50.79% vs 52.0%）、种植率（31.1% vs 47.17%）、流产率（9.38% vs 15.38%）与多胎妊娠率（25.0% vs 46.2%）差异无统计学意义（P〉0.05）。移植日子宫内膜〈8 mm时，A组患者临床妊娠率为30.76%，低于B组临床妊娠率54.54%，两者差异无统计学意义（P〉0.05）；但A组胚胎种植率明显低于B组（20% vs 52.17%），差异有统计学意义（P〈0.05）。子宫内膜厚度≥8.0 mm时，两组患者临床妊娠率（58.33% vs 63.63%）与种植率（36.36% vs 50%）差异无统计学意义（P〉0.05）。结论GH灌注联合替代周期有可能改善子宫内膜容受性，从而提高冻胚周期中薄型子宫内膜患者的临床妊娠与胚胎种植水平。Objective To investigate the effects of the frozen embryo transplantation for patients with poor outcome of endometrial growth by using growth hormone （GH） intrauterine perfusion combined with replacement cycle in the treatment of thin endometrium. Methods This was a prospective study and study participants were consecutively recruited between Jun 2014 and September 2015. A total of 88 frozen thawed embryo transfer cycles was divided into two groups from the Reproductive Center of Hunan Provincial Maternal and Child Health Hospital. Group A were 63 hormone replacement therapy （HRT） cycles and Group B were 25 GH intrauterine perfusion combined HRT cycles. Results The endometrial thickness of 22 thin endometrium patients from Group B were increased above 7 mm on progesterone day. The endometrial thickness on transplant day of Group A was （ 9.28 ±1.64） mm, which was significantly higher than Group B （7. 9 ± 0. 86 ）mm （ P 〈 0. 05 ）. The clinical pregnancy rate （ 50. 79% vs 52. 0% ）, implantation rate 31.1% vs 47. 17% ） ,miscarriage rate （9. 38% vs 15. 38% ） had no significant difference between Groups A and B. The endometrial thickness from 7 mm to 7.9 mm on transplant day, the clinical pregnancy rate （ 30. 76% vs 54. 54% ） had no significant difference in two groups （ P 〉 0.05 ）, but the implantation rate of group A was significantly lower than that of group B （20% vs 52. 17% ） （P 〈0. 05）. When the endometrial thickness was above 8 mm on transplant day, the clinical pregnancy rate （58.33% vs 63, 63% ） ,implan- tation rate （36. 36% vs 50% ） had no significant difference between groups A and B （P 〉0. 05）. Conclusions GH uterine cavity perfusion was a useful method for treatment of thin endometrium, and was helpful for improvement of endometrial thickness and receptivity, improved embryo implantation environment by assistance for HRT under the high estrogen levels.

关 键 词：生长激素 输注 胃肠外 激素替代疗法 子宫内膜 胚胎移植 

分 类 号：R714.8[医药卫生—妇产科学]