阿托西班对体外受精-胚胎移植中既往种植失败患者临床疗效的研究  

Atosiban on clinical efficacy of patients who have failed previous implantation in in vitro fertilization-embryo transfer

作　　者：吴小涛 陈冬丽[1] 郑艳萍[1] 熊承良[1] WU Xiaotao;CHEN Dongli;ZHENG Yanping;XIONG Chengliang(Reproductive Medicine Center,Tongji Medical College,Huazhong University of Science and Technology,Wuhan Hubei 430030,P.R.China)

机构地区：[1]华中科技大学同济医学院生殖医学中心,湖北武汉430030

出　　处：《中国计划生育和妇产科》2020年第7期44-47,共4页Chinese Journal of Family Planning & Gynecotokology

摘　　要：目的探讨阿托西班对既往胚胎移植失败患者行冻融胚胎移植术(frozen-thawed embryo transfer,FET)妊娠结局的影响。方法回顾性分析2017年1月至2018年3月在华中科技大学同济医学院生殖医学中心行FET患者的临床资料,排除年龄≥40岁、薄型子宫内膜(黄体酮转型日子宫内膜厚度<7 mm)、子宫器质性病变和畸形子宫等异常情况,选择至少有1次胚胎种植失败史的患者150例,其中FET前30 min静脉给予6.75 mg/0.9 m L阿托西班注射液的60例患者为观察组,移植前未予以阿托西班治疗的90例患者为对照组,比较两组患者的临床妊娠率、多胎妊娠率、流产率和异位妊娠率。结果两组患者年龄、不孕年限、抗缪勒管激素(anti-Müllerian hormone,AMH)、体质量指数(body mass index,BMI)、失败周期数、转型日子宫内膜厚度、移植胚胎数、移植优质胚胎数比较差异均无统计学意义(P>0.05),观察组临床妊娠率(58.3%)高于对照组(40%),差异有统计学意义(P<0.05);早期流产率(8.6%)低于对照组(13.9%),多胎妊娠率(37.1%)较对照组有升高趋势(22.2%),但差异无统计学意义(P>0.05);两组间异位妊娠发生率(2.78%、2.86%)比较,差异无统计学意义(P>0.05)。结论对既往种植失败的患者,在冻融胚胎解冻移植前使用阿托西班可以明显提高临床妊娠率,可能降低患者流产率。阿托西班有效降低患者的子宫内膜收缩频率,从而改善移植失败史患者的妊娠结局。Objective To explore the effect of atosiban on the outcome of frozen-thawed embryo transfer(FET) pregnancy in patients who had failed previous embryo transfer.Methods Retrospective analysis of clinical data of patients with FET performed at the Reproductive Medicine Center of Tongji Medical College,Huazhong University of Science and Technology from January 2017 to March 2018,excluding aged ≥ 40 years old,the thin endometrium(progesterone transition day endometrial thickness < 7 mm),organic lesions of the uterus and abnormal uterus,150 patients with a history of at least one embryo implantation failure were selected,of which 60 patients received 6.75 mg/0.9 m L atosiban injection intravenously 30 min before the FET for the observation group,90 patients who did not receive atosiban before transplantation were used as the control group.The clinical pregnancy rate,multiple pregnancy rate,miscarriage rate and ectopic pregnancy rate were compared between the two groups.Results The age,infertility years,anti-Müllerian hormone(AMH),body mass index(BMI),number of failure cycles,endometrial thickness of the transition day,number of embryos transferred,the number of high quality embryos of transplantation of two groups had no statistically significant difference(P>0.05).The clinical pregnancy rate of the observation group(58.3 %) was significantly higher than that of the control group(40 %),the difference was statistically significant(P<0.05);early abortion rate(8.6 %) was lower than the control group(13.9 %),the multiple pregnancy rate(37.1 %) had an increasing trend compared with the control group(22.2 %),but the difference was not statistically significant(P>0.05);The incidence of ectopic pregnancy was similar between the two groups(2.78 %,2.86 %),the difference was not statistically significant(P>0.05).Conclusion For patients with previous implant failure,the use of atosiban before thawing embryos can significantly increase the clinical pregnancy rate and may reduce the abortion rate.Atosiban effectively reduces the

关 键 词：冻融胚胎移植 阿托西班 临床妊娠率 种植失败 

分 类 号：R714.8[医药卫生—妇产科学]