人绒毛膜促性腺激素改善反复种植失败患者冻融周期子宫内膜厚度及血流的研究  

Study of human chorionic gonadotrophin in improving endometrial thickness and blood flow in recurrent implantation failure patients during frozen-thawed embryo transfer cycles

作　　者：王薇[1] 袁月 杨婷[1] 贾学玲[1] 赵丽辉[1] 胡俊平[1] 赵金珠[1] 张学红[1] Wang Wei;Yuan Yue;Yang Ting;Jia Xueling;Zhao LihuL Hu Junping;Zhao Jinzhu;Zhang Xuehong(The Reproductive Medicine Special Hospital of the 1st Hospital of Lanzhou University,Key Laboratory for Reproductive Medicine and Embryo,Lanzhou 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,730000

出　　处：《中华生殖与避孕杂志》2018年第10期837-841,共5页Chinese Journal of Reproduction and Contraception

摘　　要：目的探讨人绒毛膜促性腺激素(hCG)改善反复种植失败(RIF)患者冻融胚胎解冻移植周期(FET)子宫内膜容受性的作用效果。方法对激素替代人工周期方案准备子宫内膜拟行FET的RIF患者进行前瞻性研究,随机分为h CG组(n=275),自月经周期第7日起肌内注射h CG 150 IU/d直至胚胎移植后第6日;对照组(n=237),自月经周期第7日起肌内注射等体积0.9%生理盐水直至胚胎移植后第6日。监测移植日子宫内膜厚度、子宫内膜血流分支、放射状动脉血流搏动指数(PI)与血流阻力指数(RI)、基底区螺旋动脉PI与RI,以及胚胎种植率和临床妊娠率。结果移植日h CG组子宫内膜厚度[(9.72±0.20) mm]、子宫内膜血流分支[(5.1±1.6)支]高于对照组[(9.35±0.18) mm,P=0.033;(4.8±1.3)支,P=0.013];放射状动脉PI、放射状动脉RI组间差异无统计学意义(P>0.05);h CG组基底区螺旋动脉PI(1.03±0.17)、基底区螺旋动脉RI(0.57±0.06)均小于对照组(1.15±0.20,P=0.000;0.62±0.07,P=0.000),差异有统计学意义;hCG组胚胎种植率(38.66%)和临床妊娠率(61.40%)均显著高于对照组(30.48%,P=0.005;51.49%,P=0.025)。结论对于RIF患者,在FET周期添加小剂量h CG是有益的。h CG通过促进血管生成丰富子宫内膜的血流供应,从而增加子宫内膜厚度,提高胚胎种植率及临床妊娠率。ObjectiveTo investigate the effect of human chorionic gonadotrophin （hCG） on improving endometrial receptivity in recurrent implantation failure （RIF） patients during frozen-thawed embryo transfer （FET）. MethodsA prospective study was carried out for RIF patients with hormone replacement manual cycle program during FET. The RIF patients were randomly divided into hCG group （n=275）, in which hCG 150 IU/d was intramuscular injected from day 7 of menstrual cycle until day 6 after embryo transfer, and control group （n=237）, in which intramuscular injection of an equal volume of 0.9% saline from day 7 of menstrual cycle until day 6 after embryo transfer. Endometrial thickness, endometrial blood flow branch, radial artery blood flow pulsatility index （PI） and blood flow resistance index （RI）, basal area spiral artery blood flow PI and RI on day of embryo transfer, as well as embryo implantation rate and clinical pregnancy rate were compared between the two groups. ResultsEndometrial thickness [（9.72±0.20） mm] and endometrial blood flow branch （5.1±1.6） in hCG group were higher than those in control group [（9.35±0.18） mm, P=0.033; 4.8±1.3, P=0.013]. The radial artery blood flow PI and blood flow RI between the two groups was not statistically different （P〉0.05）. The basal area spiral artery blood flow PI （1.03±0.17） and RI （0.57±0.06） of hCG group were lower than that of control group （1.15±0.20, P=0.000; 0.62±0.07, P=0.000）. The embryo implantation rate （38.66%） and clinical pregnancy rate （61.40%） in hCG group were significantly higher than those in control group （30.48%, P=0.005; 51.49%, P=0.025）. ConclusionFor RIF patients, small dosages of hCG addition during their FET was benifit. hCG enriches endometrial blood flow by promoting angiogenesis, and finally increase endometrial thickness, embryo implantation rate and clinical pregnancy rate.

关 键 词：人绒毛膜促性腺激素(hCG) 反复种植失败(RIF) 冻融胚胎移植㈣ 内膜厚度 内膜血流 

分 类 号：R714.8[医药卫生—妇产科学]