粒细胞集落刺激因子宫腔灌注在反复着床失败患者中的临床应用观察  

Clinical application of intrauterine perfusion of granulocyte colony stimulating factor in patients with repeated implantation failure

作　　者：刘晓艳[1] 游慧娴 LIU Xiao-yan;YOU Hui-xian(Huizhou Center People Hospital Reproduction Medicine Center,Huizhou 516001)

机构地区：[1]惠州市中心人民医院生殖中心,惠州516001

出　　处：《生殖医学杂志》2021年第6期751-755,共5页Journal of Reproductive Medicine

基　　金：惠州市科技计划项目(2019Y040)。

摘　　要：目的探究宫腔内灌注粒细胞集落刺激因子(G-CSF)对反复着床失败(RIF)患者冻融胚胎移植(FET)妊娠结局的影响。方法选取2019年1月至2020年5月在我院生殖中心行FET的RIF患者,按子宫内膜厚度差异分为两组:薄型子宫内膜组(薄型组,A组):6 mm≤既往子宫内膜厚度<8 mm,共115周期;正常子宫内膜厚度组(正常组,B组):既往子内膜厚度≥8 mm,共119周期。两组患者又根据黄体酮注射日宫腔灌注G-CSF注射液用量差异各分为3个亚组,其中A1组(n=38)和B1组(n=40):黄体酮注射日宫腔灌注G-CSF注射液300μg;A2组(n=39)和B2组(n=39):黄体酮注射日宫腔灌注G-CSF注射液150μg;A3组(n=38)和B3组(n=40):对照组,未灌注G-CSF注射液。比较各组间的一般基础资料及临床妊娠结局。结果各组患者间平均年龄、不孕年限、BMI及基础生殖激素水平比较均无显著性差异(P>0.05)。在薄型子宫内膜组中,移植日子宫内膜厚度A1组>A3组>A2组,且A1组显著厚于其他两组(P<0.05);着床率和临床妊娠率A1组>A2>A3组,早期流产率A1组<A2<A3组,但均无统计学差异(P>0.05)。在正常子宫内膜组中,3亚组间移植日子宫内膜厚度、着床率、临床妊娠率均无统计学差异(P>0.05)。结论在RIF的薄型子宫内膜患者中,采用宫腔灌注G-CSF治疗,能够显著增加子宫内膜厚度,部分改善FET妊娠结局。Objective:To explore the effect of intrauterine infusion of granulocyte colony-stimulating factor(G-CSF)on pregnancy outcome of frozen-thawed embryo transfer(FET)in patients with repeated implantation failure(RIF).Methods:The RIF patients who underwent FET in the reproductive center of our hospital from January 2019 to May 2020 were divided into two groups according to the endometrial thickness:thin endometrial group(group A,115 cycles):6 mm≤endometrial thickness<8 mm;normal endometrial thickness group(group B,119 cycles):endometrial thickness≥8 mm.The two groups were subdivided into three groups:intrauterine infusion of 300μg G-CSF on the day of progesterone injection in group A1(n=38)and group B1(n=40);intrauterine infusion of 150μg G-CSF on the day of progesterone injection in group A2(n=39)and group B2(n=39);No G-CSF intrauterine infusion of G-CSF in group A3(n=38)and group B3(n=40).The general basic data and clinical pregnancy outcomes were compared among the groups.Results:There were no significant differences in average age,years of infertility,BMI and basal reproductive hormone levels among the groups(P>0.05).In the thin endometrial group,the endometrial thickness on the transplantation day was group A1>group A3>group A2,and endometria of group A1 was significantly thicker than that of the other two groups(P<0.05).The implantation rate and clinical pregnancy rate were group A1>group A2>group A3,and the early abortion rate was group A1<group A2<group A3,but there was no significant difference(P>0.05).In the normal endometrial thickness group,there was no significant difference in the endometrial thickness,implantation rate and clinical pregnancy rate among the three subgroups(P>0.05).Conclusions:In RIF patients with thin endometrium,intrauterine infusion of G-CSF can significantly increase the endometrial thickness and partially improve the pregnancy outcome of FET.

关 键 词：粒细胞集落刺激因子 反复着床失败 子宫内膜厚度 

分 类 号：R714.8[医药卫生—妇产科学]