子宫内膜容受性检测在反复种植失败患者体外受精-胚胎移植中的应用  

Application of endometrial receptivity test in IVF-ET of patients with repeated implantation failure

作　　者：袁振亚 袁牧 林继慧 黄晓洁[1] 朱云霞[1] 宋雪梅[1] YUAN Zhen-ya;YUAN Mu;LIN Ji-hui;HUANG Xiao-jie;ZHU Yun-xia;SONG Xue-mei(Center for Reproductive Medicine of Xuzhou Maternity&Child Health Care Hospital,Xuzhou 221009)

机构地区：[1]徐州市妇幼保健院生殖医学中心,徐州221009

出　　处：《生殖医学杂志》2022年第10期1327-1333,共7页Journal of Reproductive Medicine

基　　金：江苏省妇幼健康科研项目(F202162)。

摘　　要：目的评估子宫内膜容受性检测(ERT)技术在反复种植失败(RIF)患者冻融胚胎移植(FET)周期中的应用效果。方法将接受ERT评估(基于转录组测序的ERT技术模型)的RIF患者(ERT组,n=60)与未接受ERT评估的RIF患者(非ERT组,n=151)、非RIF患者(非RIF组,n=503)的FET结局进行比较。结果接受ERT评估的RIF患者中绝大部分(58/60,96.67%)的内膜容受期推迟了1~2 d,根据ERT评估结果相应调整了移植时间。FET结果显示,与非ERT组比较,ERT组胚胎种植率(53.25%vs.35.07%)、宫内妊娠率(66.67%vs.45.70%)、活产率(55.00%vs.29.80%)均显著升高(P<0.05),且与非RIF组相当(P>0.05)。不同移植策略(1~2枚卵裂期胚胎、1枚囊胚移植、1枚卵裂期胚+1枚囊胚序贯移植)下,ERT组宫内妊娠率、活产率均显著高于非ERT组(P<0.05)。结论对RIF患者进行ERT,调整移植时间进行移植,可显著改善RIF患者的FET结局。Objective:To assess the application effect of endometrial receptivity test(ERT)in frozen-thawed embryo transfer(FET)cycles of patients with repeated implantation failure(RIF).Methods:The FET outcomes of RIF patients who received ERT evaluation(ERT technology model based on transcriptome sequencing)(ERT group,n=60)were compared with RIF patients who did not who received ERT evaluation(non-ERT group,n=151)and non-RIF patients(non-RIF group,n=503).Results:Endometrial receptivity period of most RIF patients(58/60,96.67%)evaluated by ERT was delayed by 1 to 2 days,and the transplantation time was adjusted according to the ERT results.FET results showed that embryo implantation rate(53.25%vs.35.07%),intrauterine pregnancy rate(66.67%vs.45.70%)and live birth rate(55.00%vs.29.80%)of RIF patients with ERT were significantly higher than RIF patients without ERT(P<0.05),and equal to patients without RIF(P>0.05).In different FET strategies,including transferring 1 to 2 cleavage embryos,1 blastocyst or 1 cleavage embryo plus 1blastocyst sequential transfer,the intrauterine pregnancy rate and live birth rate of RIF patients with ERT were all significantly higher than RIF patients without ERT(P<0.05).Conclusions:The FET outcome of RIF patients can be significantly improved by performing ERT and adjusting the transplantation time.

关 键 词：反复种植失败 子宫内膜容受性 胚胎种植率 宫内妊娠率 活产率 

分 类 号：R711.6[医药卫生—妇产科学]