自然周期与激素替代周期准备内膜对冻融胚胎移植结局的影响  

Effect of Natural and Hormone Replacement Cycle Preparing Endometrium on Frozen-thawed Embryo Transfer Outcome

作　　者：李艳梅[1] 马晓玲[1] 张莉莉[1] 张学红[1] 赵丽辉[1] 何晓霞[1] 王乃辉[1] LI Yanmei;MA Xiaoling;ZHANG Lili(Reproductive Medicine Hospital,the First Hospital of Lanzhou University,Key Laboratory for Reproductive Medicine and Embryo Gansu Province,Lanzhou Gansu 730000,China)

机构地区：[1]兰州大学第一医院生殖医学专科医院甘肃省生殖医学与胚胎重点实验室,甘肃兰州730000

出　　处：《实用妇产科杂志》2018年第10期774-777,共4页Journal of Practical Obstetrics and Gynecology

基　　金：兰州市人才创新创业项目(编号:2016-RC-51)

摘　　要：目的:探讨同一黄体支持剂量时两种内膜准备方案对冻融胚胎移植妊娠结局的影响。方法:回顾性分析2016年1月至2016年12月在兰州大学第一医院生殖医学专科医院采用自然周期和激素替代周期准备内膜,并采用相同剂量黄体支持的冻融胚胎移植(FET) 233例患者资料,其中自然周期121例,激素替代周期112例。比较不同内膜准备方案患者的年龄、体质量指数(BMI)、多囊卵巢综合征(PCOS)/排卵障碍比例、ICSI比例、移植胚胎数、移植日子宫内膜厚度、临床妊娠率、早期流产率、晚期流产率、早产率及活产率等。结果:自然周期组年龄大于激素替代周期组(31. 99岁vs 30. 89岁),BMI(21. 35 kg/m2vs 22. 23 kg/m2)、PCOS/排卵障碍比例(4. 13%vs 19. 64%)小于人工周期组,差异有统计学意义(P<0. 05)。两组移植胚胎数、有优胚移植比例、胚胎种植率、多胎率比较,差异无统计学意义(P>0. 05)。自然周期组和激素替代周期组患者临床妊娠率(57. 85%vs65. 18%)、早期流产率(13. 04%vs 15. 28%)、晚期流产率(1. 45%vs 4. 17%)、早产率(28. 81%vs36. 21%)、活产率(85. 51%vs 80. 56%)比较,差异无统计学意义(P>0. 05)。结论:足量黄体支持的情况下,在冻融胚胎移植中自然周期和激素替代周期准备内膜均可获得相似的妊娠结局,临床工作中可根据实际情况灵活选择。Objective： To investigate the clinical outcome of the transfer of frozen-thawed embryo after two different endometrium preparation programs when receiving luteal support of the same dose.Methods： The data of 233 FET cycles which administrated with the same dose of luteal support were retrospectively analyzed in our center from January 2016 to December 2016. 121 natural cycles and 112 hormone replacement cycles were enrolled.The age of patients,BMI,proportion of PCOS or ovulatory disorders,proportion of ICSI,number of embryos transferred,endometrial thickness on the transfer day,clinical pregnancy rate,early and late abortion rate,premature delivery rate and live birth rate between two groups were compared.Results： In natural cycle group,the patients were much older（ 31. 99 vs 30. 89）,while the BMI（ 21. 35 kg/m2 vs 22. 23 kg/m2） and the proportion of PCOS or ovulatory disorders were significantly lower（ 4. 13% vs 19. 64%） than those in hormone replacement therapy group（ P 0. 05）.There was no significant difference in the numbers of transplanted embryos,the proportion of patients with excellent embryos transferred,the rate of implantation or multiple pregnancy between the natural cycle group and hormone replacement group（ P〉0. 05）.There was no significant difference in the clinical pregnancy rate（ 57. 85%vs 65. 18%）,early abortion rate（ 13. 04% vs 15. 28%）,late abortion rate（ 1. 45% vs 4. 17%）,premature delivery rate（ 28. 81% vs 36. 21%） or live birth rate（ 85. 51% vs 80. 56%） between the two groups（ P〉0. 05）.Conclusions：The similar pregnancy outcomes could be obtained either with natural or hormone replacement preparing the endometrium during frozen-thawed embryo transfer when using a sufficient luteal support.The suitable choice could be made flexibly according to the actual needs.

关 键 词：自然周期 激素替代周期 黄体支持 冻融胚胎移植 妊娠结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]