倾向性得分匹配分析两种内膜准备方案对PCOS患者冻融胚胎移植周期临床妊娠率和早期流产率的影响  

Impact of endometrial preparation protocols on clinical pregnancy rate and early miscarriage rate after frozen-thawed embryos transfer in women with polycystic ovary syndrome:a propensity matching analysis

作　　者：冯铿 朱玲玲[1] 李德荣 李翔 张丽华 黎微微 廖玉娟[1] 钟俊洁 罗宇迪[1] FENG Keng;ZHU Ling-ling;LI De-rong;LI Xiang;ZHANG Li-hua;LI Wei-wei;LIAO Yu-juan;ZHONG Jun-jie;LUO Yu-di(Reproductive Medicine Center,Yulin Maternal and Child Health Hospital,Yulin 537000)

机构地区：[1]玉林市妇幼保健院生殖中心,玉林537000

出　　处：《生殖医学杂志》2023年第6期855-860,共6页Journal of Reproductive Medicine

基　　金：广西壮族自治区卫生和计划生育委员会自筹经费科研项目(Z20211469)。

摘　　要：目的探讨两种不同内膜准备方案对多囊卵巢综合征(PCOS)患者冻融胚胎移植(FET)周期临床妊娠率和早期流产率的影响。方法回顾性分析2016年1月至2022年11月于玉林市妇幼保健院生殖中心进行FET助孕的PCOS患者的临床资料,共535个周期。根据内膜准备方案不同分为两组:激素替代方案组(HRT组,353个周期)和促排卵周期组(来曲唑组,182个周期)。将女方年龄、不孕年限、体质量指数(BMI)、新鲜周期获卵个数、基础生殖激素水平、抗苗勒管激素(AMH)、转化日雌二醇(E 2)、转化日孕酮(P)、内膜厚度、移植胚胎数、移植囊胚率、移植优胚率纳入匹配变量,通过1∶1倾向性评分匹配(PSM)使两组基本情况达到匹配,比较匹配后两组临床妊娠率和早期流产率的差异。结果PSM前后结果相同,两组患者的临床妊娠率、早期流产率差异均无统计学意义(P>0.05)。结论PCOS患者FET周期采用激素替代方案或来曲唑促排卵内膜准备方案,具有相似的临床妊娠率、早期流产率。Objective:To compare the effects of two different endometrial preparation protocols on the clinical pregnancy rate and early miscarriage rate after frozen-thawed embryos transfer(FET)in women with polycystic ovary syndrome(PCOS).Methods:The clinical data of the PCOS patients(535 cycles)who received FET treatment in Reproductive Medicine Center of Yulin Maternal and Child Health Hospital from January 2016 to November 2022 were retrospectively analyzed.According to endometrial preparation protocol,the cycles were divided in to hormone replacement group(n=353)and letrozole group(n=182).The age,body mass index(BMI),duration of infertility,number of oocytes retrieved in fresh cycles,basic reproductive hormone levels,anti-mullerian hormone(AMH)level,levels of estrogen&progesterone on progesterone conversion day,endometrial thickness,numbers of embryo transferred,blastocysts transferred rate of the patients were included in matching variables,and 1∶1 propensity score matching(PSM)was used to match the basic information of the patient in the two group.After matching,each group had 50 cycles included in the analysis.The clinical pregnancy rate and early miscarriage rate were compared between the two group.Results:The results before and after PSM are the same.There were no significant difference in clinical pregnancy rate and early miscarriage rate between the two group(P>0.05).Conclusions:PCOS patients with hormone replacement therapy or letrozole induced ovulation protocol for endometrial preparation during the FET cycle have similar clinical pregnancy rates and early miscarriage rates.

关 键 词：来曲唑 多囊卵巢综合征 冻融胚胎移植 临床妊娠率 早期流产率 

分 类 号：R711.6[医药卫生—妇产科学]