两种剂量来曲唑促排卵方案用于FET内膜准备临床结局的比较  

Comparison of clinical outcome of two ovulation induction protocol with different doses of letrozole for endometrial preparation in frozen-thawed embryo transfer cycles

作　　者：赖春田 曹蓓 LAI Chun-tian;CAO Bei(Reproductive Medicine Center of Zhuzhou Central Hospital,Zhuzhou 412000)

机构地区：[1]株洲市中心医院生殖医学中心,株洲412000

出　　处：《生殖医学杂志》2021年第9期1158-1163,共6页Journal of Reproductive Medicine

摘　　要：目的比较两种剂量来曲唑(LE)促排卵方案用于冻融胚胎移植(FET)周期子宫内膜准备对妊娠结局的影响。方法收集2019年5月至2020年5月在我院首次行FET助孕的73例患者为研究对象。按照随机数字表将患者随机分为低剂量组(给予LE 2.5 mg,35例)和高剂量组(给予LE 5.0 mg,38例)。选择同期40个月经周期规律的FET周期作为对照,即自然周期组。比较各组患者的一般资料、实验室指标及妊娠结局。结果各组患者的一般资料比较均无显著性差异(P>0.05)。各组患者实验室指标比较,高剂量组的成熟卵泡数显著高于低剂量组和自然周期组(P<0.05);低剂量组与高剂量组LH峰日/HCG日卵泡直径均显著高于自然周期组(P<0.05);低剂量组和高剂量组的LH峰值显著低于自然周期组(P<0.05);LH峰日/HCG日内膜厚度比较,自然周期组厚度最佳,低剂量组显著高于高剂量组(P<0.05);低剂量组的A型内膜占比显著高于其他两组(P<0.05),高剂量组的A型内膜占比显著高于自然周期组(P<0.05);低剂量组和高剂量组的C型内膜占比显著低于自然周期组(P<0.05)。各组妊娠结局比较,低剂量组与自然周期组的胚胎着床率、临床妊娠率、活产率均显著高于高剂量组(P<0.05);周期取消率3组间比较,高剂量组最高,自然周期组最低(P均<0.05)。结论对于平素月经不规律但卵巢功能正常的患者,LE 2.5 mg应用于FET周期准备内膜的临床效果和自然周期相似,都能获得理想的妊娠结局。而LE 5.0 mg的应用剂量妊娠结局相对较差,提示低剂量LE促排卵是一种可供选择的FET周期内膜准备方案。Objective:To compare the effects of two different doses of letrozole(LE)on pregnancy outcome in frozen-thawed embryo transfer(FET)cycles.Methods:A total of 73 patients who underwent the first FET assisted pregnancy in our hospital from May 2019 to May 2020 were selected as the research objects.According to the random number table,the patients were randomly divided into low-dose group(35 patients were given LE 2.5 mg)and high-dose group(38 patients were given LE 5.0 mg).During the same period,40 FET cycles with regular menstrual cycles were selected as the control(natural control group).The general information,laboratory indexes and pregnancy outcomes of the patients in each group were compared.Results:There was no significant difference in the general information of patients among the groups(P>0.05).The average mature follicle number of high-doses group was significantly more than that low-doses group and natural cycle group(P<0.05).The average follicle diameter of both LE group was significantly larger than that of natural cycle group(P<0.05).The peak value of LH in low-dose group and high-dose group was significantly lower than that in natural cycle group(P<0.05).The endometrial thickness on LH peak day/HCG day in the natural cycle group was the best,and that in the low-dose group was significantly higher than that in the high-dose group(P<0.05).The proportion of type A endometrium in the low-dose group was significantly higher than that in the other two groups(P<0.05),and the proportion of type A endometrium in the high-dose group was significantly higher than that in the natural cycle group(P<0.05).The proportion of type C endometrium in low-dose group and high-dose group was significantly lower than that in natural cycle group(P<0.05).The implantation rate,clinical pregnancy rate and live birth rate in low-dose group and natural cycle group were significantly higher than those in high-dose group(P<0.05).Among the three groups,the cycle cancellation rate in the high-dose group was the highest,and that in the

关 键 词：冻融胚胎移植 来曲唑 促排卵 自然周期 

分 类 号：R711.6[医药卫生—妇产科学]