降调节后激素替代方案中应用生长激素对冻融胚胎移植周期结局的影响  

Effects of growth hormone in down-regulating hormone replacement cycle on the outcome of frozen-thawed embryo transfer

作　　者：王娜玉 张娜[1] 吕翠婷[1] 甄秀丽[1] 范春辉 赵静云[1] Wang Nayu;Zhang Na;Lyu Cuiting;Zhen Xiuli;Fan Chunhui;Zhao Jingyun(Reproductive Medicine Center,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院生殖医学科,石家庄050011

出　　处：《中华生殖与避孕杂志》2021年第11期973-979,共7页Chinese Journal of Reproduction and Contraception

摘　　要：目的:探讨冻融胚胎移植(frozen-thawed embryo transfer,FET)周期中应用生长激素是否能改善患者的妊娠结局。方法:回顾性队列研究2015年1月至2018年7月期间于河北医科大学第四医院生殖医学科行FET的1042个降调节后激素替代周期的临床资料。根据是否应用生长激素将患者分为生长激素组(A组)和未应用生长激素组(B组),分别比较高龄(≥35岁)、多囊卵巢综合征(polycystic ovary syndrome,PCOS)、反复种植失败患者中A、B两组间的临床结局。结果:A组女方年龄[(31.1±4.5)岁]、临床妊娠率[67.1%(114/170)]均高于B组[(30.1±4.4)岁、57.5%(501/872)](P=0.010,P=0.020)。高龄患者A组与B组的胚胎种植率、临床妊娠率、流产率及活产率差异均无统计学意义(P均>0.05)。PCOS患者A组的活产率[65.8%(25/38)]明显高于B组[42.3%(96/227)](P=0.007)。反复种植失败患者A组的种植率[37.3%(57/153)]、临床妊娠率[50.5%(46/91)]、活产率[37.4%(34/91)]明显高于B组[23.0%(115/501)、29.1%(92/316)、21.8%(69/316)](P<0.001、P<0.001、P=0.003)。结论:高龄患者应用生长激素并不能改善FET的妊娠结局。PCOS患者应用生长激素可有效提高活产率。反复种植失败患者应用生长激素可以明显提高种植率、临床妊娠率和活产率。Objective To analyze whether the application of growth hormone(GH)in the frozen-thawed embryo transfer(FET)cycle can improve the pregnancy outcome of patients.Methods The retrospective cohort study including 1042 FET cycles was carried out between January 2015 to July 2018 in Reproductive Medicine Center,the Fourth Hospital of Hebei Medical University.According to medication before transfer,all patients were divided into GH group(group A)and no GH group(group B).The pregnancy outcomes were compared between the two groups in aged patients(≥35 years),polycystic ovary syndrome(PCOS)patients and repeated implantation failure(RIF)patients.Results In group A,the maternal age[(31.1±4.5)years old]and the clinical pregnancy rate[67.1%(114/170)]were higher than those in group B[(30.1±4.4)years old,57.5%(501/872)](P=0.010,P=0.020).There were no significant differences in the implantation rate,the clinical pregnancy rate,the abortion rate and the live birth rate between group A and group B in aged patients(all P>0.05).In PCOS patients,the live birth rate in group A[65.8%(25/38)]was significantly higher than that in group B[42.3%(96/227)](P=0.007).In the RIF patients,the implantation rate[37.3%(57/153)],the clinical pregnancy rate[50.5%(46/91)]and the live birth rate[37.4%(34/91)]in group A were significantly higher than those in group B[23.0%(115/501),29.1%(92/316),21.8%(69/316)](P<0.001,P<0.001,P=0.003).Conclusion For the aged patients,adding GH could not improve pregnancy outcomes.The application of GH in PCOS patients could increase the live birth rate.For the RIF patients,the application of GH could increase the implantation rate,the clinical pregnancy rate and the live birth rate.

关 键 词：冻融胚胎移植 激素替代 生长激素 妊娠率 反复种植失败 

分 类 号：R714.8[医药卫生—妇产科学]