人绒毛膜促性腺激素在冻融胚胎移植激素替代周期内膜转化日的应用  

Application of human chorionic gonadotropin on the day of endometrial transformation in the hormone replacement therapy of frozen-thawed embryo transfer

作　　者：王葳[1] 曹义娟[2] 汤美玲[1] 周晓燕[1] WANG Wei;CAO Yijuan;TANG Meiling;ZHOU Xiaoyan(Department of Reproductive Medicine,The General Hospital of Wanbei Coal-Electricity Group,Suzhou,Anhui 234000,China;Reproductive Medical Center,Xuzhou Central Hospital,Xuzhou,Jiangsu 221000,China)

机构地区：[1]皖北煤电集团总医院生殖医学科,安徽宿州234000 [2]徐州市中心医院生殖中心,江苏徐州221000

出　　处：《安徽医药》2021年第6期1154-1158,共5页Anhui Medical and Pharmaceutical Journal

基　　金：徐州市科技计划项目(KC17104)。

摘　　要：目的探讨冻融胚胎移植(FET)激素替代周期(HRT)内膜转化日低黄体生成素(LH)时肌注人绒毛膜促性腺激素(hCG)对妊娠结局的影响。方法回顾性分析2018年1月至2019年12月在皖北煤电集团总医院生殖医学科行FET激素替代方案助孕共271个周期的临床资料。根据内膜转化日低LH时是否肌注hCG分为hCG组(45周期)和对照组(95周期),同时期未使用hCG治疗的病人,根据内膜转化日LH值分为高LH组(LH≥13 U/L,131周期)和低LH组(即前面对照组,LH<13 U/L,95周期),分别比较各组的临床指标。结果hCG组胚胎种植率[37.65%(32/85)]、临床妊娠率[62.22%(28/45)]高于对照组[25.55%(46/180)、43.43%(43/99)](P<0.05)。高LH组体质量指数、内膜转化日雌二醇值及早期流产率[4.41%(3/68)]低于低LH组[17.07%(7/41)](P<0.05),高LH组胚胎种植率[34.66%(87/250)]高于低LH组[25.55%(46/180)](P<0.05)。结论在冻融胚胎移植激素替代周期中低LH不利于胚胎种植及妊娠维持;低LH时在内膜转化日肌注hCG可以改善胚胎种植率,提高临床妊娠率,但不能降低早期流产率。Objective To explore the effect of intramuscular injection of human chorionic gonadotropin(hCG)on pregnancy outcome during the hormone replacement therapy(HRT)of frozen-thawed embryo transfer(FET)with low luteinizing hormone(LH)on endometrial transformation day.Methods The clinical data of 271 cycles of FET hormone replacement therapy,which was carried out in Reproductive Medicine Department of the General Hospital of Wanbei Coal-Electricity Group from January 2018 to December 2019,were analyzed retrospectively.According to whether or not hCG was intramuscularly injected at low LH on endometrial transformation day,patients were assigned into hCG group(45 cycles)and control group(95 cycles).Patients who did not use hCG at the same time were assigned into high LH group(LH≥13 U/L,131 cycles)and low LH group(control group,LH<13 U/L,95 cycles)according to the value of LH on endometrial transformation day.The clinical indexes of all groups were compared.Results The embryo implantation rate[37.65%(32/85)]and the clinical pregnancy rate[62.22%(28/45)]of hCG group were higher than those of control group[25.55%(46/180),43.43%(43/99)](P<0.05).The body mass index(BMI),estradiol(E2)value on endometrial transformation day and early abortion rate[4.41%(3/68)]of the high LH group were lower than those of the low LH group[17.07%(7/41)](P<0.05).And the embryo implantation rate[34.66%(87/250)]of the high LH group was higher than that of the low LH group[25.55%(46/180)](P<0.05).Conclusions Low LH in the hormone replacement therapy of frozen-thawed embryo transfer is not conductive to embryo implantation and pregnancy maintenance.Intramuscular injection of hCG on endometrial transformation day with low LH could improve embryo implantation rate and clinical pregnancy rate,but could not reduce the early abortion rate.

关 键 词：胚胎移植 妊娠结局 子宫内膜 激素替代周期 人绒毛膜促性腺激素 

分 类 号：R714.8[医药卫生—妇产科学]