冻融胚胎移植的内膜准备  

Preparation of endometrium before frozen-thawed embryo transfer

作　　者：牛志宏[1] 冯云 NIU Zhi- hong;FENG Yun(Reproductive Medical Center,Ruijin Hospital Affiliated to Medical School,Shanghai Jiaotong University,Shanghai 20002)

机构地区：[1]上海交通大学医学院附属瑞金医院生殖医学中心,上海200025

出　　处：《生殖医学杂志》2018年第8期713-717,共5页Journal of Reproductive Medicine

摘　　要：子宫内膜准备是冻融胚胎移植技术的关键环节。内膜准备方案主要包括自然周期、改良自然/半替代周期、激素替代周期(降调节/不降调节)和卵巢刺激周期。尚未发现以上方案在临床妊娠结局方面存在显著性差异,降调节后的激素替代周期在部分人群中可能更有优势。阴道给药和肌肉注射补充孕酮,临床结局并无差异。孕酮暴露时间在3.5~5d均可实施冻融D3胚胎移植。部分女性存在内膜与胚胎不同步,需根据内膜组织学特征适当延长孕酮暴露时间。薄型内膜的处理效果与病因密切相关。Endometrial preparation is a key part of frozen thawed embryo transfer technology. The endometrium preparation protocols mainly include natural cycle, modified natural/semi replacement cycle, hormone replacement cycle （down regulation/non down regulation）and ovarian stimulation cycle. No significant differences in the clinical pregnancy outcomes of the above regimens have been found. The hormone replacement cycle with clown regulation may be more advantageous in particular patients. There was no difference in clinical outcomes between vaginal administration and intramuscular injection of progesterone. For Day 3 embryos, embryo transfer can be performed at 3.5 to 5 days after progesterone exposure. There is unsynchronized endometrium in some women. For them, progesterone exposure time should be appropriately extended according to the histological features of the endometrium. The treatment effect of thin endometrium is closely related to the etiology.

关 键 词：子宫内膜 孕酮 妊娠 激素替代 

分 类 号：R714.8[医药卫生—妇产科学]