低分子肝素钠在首次种植失败患者再次解冻移植周期中的应用  

Application of low molecular weight heparin in thawed transplantation cycle in the patients with the first transplant failure

作　　者：巩晓芸[1] 腊晓琳[1] 李霞[1] 王青丽[1] 玛依热·吐尔逊[1] 艾海权[1] GONG Xiaoyun;LA Xiaolin;LI Xia;WANG Qingli;Mayire Tuerxun;AI Haiquan(Departmengt of Reproductive, the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054, China)

机构地区：[1]新疆医科大学第一附属医院生殖医学中心生殖医学科,乌鲁木齐830054

出　　处：《新疆医科大学学报》2020年第9期1200-1203,共4页Journal of Xinjiang Medical University

基　　金：新疆维吾尔自治区自然科学基金面上项目(2017D01C283)。

摘　　要：目的探讨低分子肝素钠是否能够改善首次种植失败患者再次解冻移植周期妊娠结局。方法回顾性分析2017年9月-2019年9月在新疆医科大学第一附属医院生殖医学中心首次种植失败再次解冻移植且年龄≤35岁患者(共计321个解冻周期)的临床资料,按照转化日开始是否添加低分子肝素钠分为两组:添加低分子肝素钠组(A组,162个解冻周期)、未添加低分子肝素钠组(B组,159个解冻周期),比较两组患者一般资料、移植周期特征、临床结局及不良反应等是否存在差异。结果两组患者年龄、不孕时间、体质指数(BMI)、基础卵泡刺激素(bFSH)、抗缪勒管激素(AMH)水平差异均无统计学意义;A组不良妊娠史构成比略高于B组,但差异无统计学意义;移植周期特征方面,两组患者移植胚胎构成比、平均移植胚胎数、优胚率及转化日子宫内膜厚度差异均无统计学意义;妊娠结局方面,A组生化妊娠率(56.79%vs 53.46%)、临床妊娠率(54.94%vs 50.94%)、胚胎种植率(43.06%vs 37.81%)及持续妊娠率(87.64%vs 87.72%)均略高于B组,B组早期流产率(8.99%vs 13.58%)高于A组,但差异无统计学意义(P>0.05);两组未见明显不良反应发生。结论低分子肝素钠在首次胚胎移植患者再次解冻移植周期中应用未出现明显不良副作用,但并不能明显改善患者助孕临床结局,因此在今后的临床诊疗工作中仍需谨慎使用。Objective To investigate whether low molecular weight heparin(LMWH)can improve the pregnancy outcome of the thawed transplantation cycle in patients who failed the first time implantation.Methods A total of 321 cycles with≤35 year-old who received FET from September 2017 to September 2019 were analyzed retrospectively,then they were divided into group A(LMWH group,162 cycles)and group B(No LMWH group,159 cycles).General informations,cycle characteristics,clinical outcomes and adverse reaction were analyzed,and a comparative analysis was conducted.Results Two groups were not statistically different in general informations and cycle characteristics;group A has a slightly higher than group B in biochemical pregnancy rate(56.79%vs 53.46%),clinical pregnancy rate(54.94%vs 50.94%)embryo implantation rate(43.06%vs 37.81%)and sustained pregnancy rate(87.64%vs 87.72%),and the rate of early abortion in group A was slightly lower than in group B.However,there was no statistical difference among these indicators.In terms of adverse reactions,no significant adverse reactions were observed in group A compared with group B.Conclusion There were no significant adverse side effects in patients added LMWH,but it could not significantly improve the clinical outcome of assisted pregnancy in these patients,so it still needs to be used cautiously in the future.

关 键 词：低分子肝素钠 种植失败 冻融胚胎移植 

分 类 号：R711.6[医药卫生—妇产科学]