冻融单囊胚移植中内膜准备方案对薄型子宫内膜患者妊娠结局和新生儿结局的影响  

Effect of endometrial preparation protocol on outcome of pregnancy and neonates in patients with thin endometrium during single frozen-thawed blastocyst transfer

作　　者：李莹[1] 吴佩蔚[1] 黄亚哲[1] 张帅[1] 王琳 韩中将 陈建玲[1] LI Ying;WU Pei-wei;HUANG Ya-zhe;ZHANG Shuai;WANG Lin;HAN Zhong-jiang;CHEN Jian-ling(Department of Reproductive Medicine,Nanyang Central Hospital,Nanyang 473000)

机构地区：[1]南阳市中心医院生殖医学科,南阳473000

出　　处：《生殖医学杂志》2023年第4期549-554,共6页Journal of Reproductive Medicine

基　　金：河南省医学科技攻关计划(联合共建)项目(LHGJ20190319)。

摘　　要：目的研究冻融单囊胚移植周期中内膜准备方案(自然周期和激素替代周期)对薄型子宫内膜患者临床妊娠结局和新生儿结局的影响。方法回顾性分析2019年8月至2021年11月于本院生殖医学中心行冻融单囊胚移植的薄型子宫内膜患者的90个移植周期,根据内膜准备方案不同分为自然周期组(48个周期)和激素替代周期组(42个周期)。比较两种方案组间基础资料、临床妊娠结局及新生儿结局。结果两组基础临床资料比较差异均无统计学意义(P>0.05)。自然周期组早期流产率显著低于激素替代周期组(4.76%vs.22.22%,P<0.05),而组间胚胎着床率、临床妊娠率、晚期流产率、异位妊娠率、剖宫产率、活产率以及妊娠期并发症、分娩孕周等比较均无统计学差异(P>0.05)。自然周期组新生儿早产率(5.26%vs.41.67%)及低体质量出生儿发生率(5.26%vs.33.33%)显著低于激素替代周期组(P<0.05),而正常体质量出生儿发生率(84.21%vs.58.33%)显著高于激素替代周期组(P<0.05);两组间新生儿畸形率、巨大儿发生率比较均无统计学差异(P>0.05)。结论薄型子宫内膜患者行冻融单囊胚胎移植时内膜准备采用自然周期方案可能降低早期流产率、新生儿早产率及低体质量新生儿发生率。Objective:To investigate the effects of endometrial preparation protocol(natural cycle and hormone replacement cycle)in single frozen-thawed blastocyst transfer on outcomes of pregnancy and neonates in patients with thin endometrium.Methods:Ninety transfer cycles of single frozen-thawed blastocyst transfer at the Center for Reproductive Medicine of our hospital from August 2019 to November 2021 were retrospectively analyzed.The cycles were divided into natural cycle group(48 cycles)and hormone replacement cycle group(42 cycles)according to the endometrial preparation protocol.The basic data,clinical pregnancy and neonatal outcome were compared between the two protocols.Results:There was no significant difference in basic clinical data between the two groups(P>0.05).The early abortion rate in the natural cycle group was significantly lower than that in the hormone replacement cycle group(4.76%vs.22.22%,P<0.05).There were no significant differences in embryo implantation rate,clinical pregnancy rate,late abortion rate,ectopic pregnancy rate,cesarean section rate,live birth rate,pregnancy complications and gestational weeks at delivery between the two groups(P>0.05).The preterm birth rate(5.26%vs 41.67%)and the incidence of low birth weight(5.26%vs.33.33%)in the natural cycle group were significantly lower than those in the hormone replacement cycle group(P<0.05),and the incidence of normal birth weight neonates(84.21%vs.58.33%)was significantly higher than that in the hormone replacement cycle group(P<0.05).There was no significant difference in neonatal malformation rate and macrosomia rate between the two groups(P>0.05).Conclusions:The natural cycle protocol can reduce the early abortion rate,premature birth and low birth weight neonates in patients with thin endometrium undergoing single frozen-thawed blastocyst transfer.

关 键 词：自然周期 激素替代周期 冻融单囊胚移植 母婴结局 

分 类 号：R711.76[医药卫生—妇产科学]