不同移植策略对反复着床失败患者临床结局的影响  

Impacts of different implantation strategies on clinical outcome of patients with repeated implantation failure

作　　者：马双影 洪名云[1] MA Shuangying;HONG Mingyun(Anhui Province Maternity and Child Health Hospital Affiliated to Anhui Medical University,Anhui,Hefei 230001,China)

机构地区：[1]安徽医科大学附属妇幼保健院,安徽合肥230001

出　　处：《中国医药科学》2023年第13期13-16,共4页China Medicine And Pharmacy

基　　金：安徽省卫生健康委科研项目(AHWJ2021b127);安徽省合肥市第六周期医学重点专科建设项目;安徽省合肥市自主创新政策“借转补”资金项目(J2018Y03)。

摘　　要：目的比较不同移植策略对反复移植失败患者冻胚移植周期临床结局的影响,为反复着床失败(RIF)患者的临床诊疗提供理论参考。方法回顾性分析2018年7月至2022年5月在安徽医科大学附属妇幼保健院RIF患者再次行冻胚移植的患者,按照处理方法不同分为四组,其中A组为对照组(共53个周期),B组为序贯移植组(共41个周期),C组为人绒毛膜促性腺激素(HCG)宫腔灌注组(共58个周期),D组为内膜搔刮组(共51个周期),比较各组之间的一般资料、冻胚移植相关指标及临床结局。结果四组的一般资料及冻胚移植相关指标比较,差异无统计学意义(P>0.05)。B组的临床妊娠率在四组中最高,与对照组A组比较,差异有统计学意义(P<0.05);C组、D组的临床妊娠率与对照组A组比较,差异无统计学意义(P>0.05)。各组间双胎妊娠率、种植率、流产率以及异位妊娠率比较,差异无统计学意义(P>0.05)。结论三种处理方法都有改善RIF患者临床结局的趋势,其中序贯移植不仅能显著RIF患者的提高临床妊娠率,而且其双胎妊娠的风险在四组中最低。Objective To compare the impacts of different implantation strategies on the clinical outcome of frozen embryo transfer cycles in patients with repeated implantation failure(RIF),and to provide theoretical reference for clinical diagnosis and treatment of patients with RIF.Methods The patients who underwent frozen embryo transfer again in the Anhui Province Maternity and Child Health Hospital Affiliated to Anhui Medical University from July 2018 to May 2022 were retrospectively analyzed.According to different treatment methods,they were divided into group A(the control group,n=53 cycles),group B(the sequential implantation group,n=41 cycles),group C(the intrauterine infusion of human chorionic gonadotropin(HCG)group,n=58 cycles)and group D(the endometrial curettage group,n=51 cycles).The general data,related indices of frozen embryo transfer and clinical outcomes were compared among the groups.Results There were no statistically significant differences in general data and related indices of frozen embryo transfer in the four groups(P>0.05).The clinical pregnancy rate in group B was the highest in the four groups,with statistically significant difference compared to group A(the control group)(P<0.05).There was no statistically significant difference in the clinical pregnancy rate between group C,group D and group A(the control group)(P>0.05).There were no statistically significant differences in twin pregnancy rate,implantation rate,abortion rate and ectopic pregnancy rate among the groups(P>0.05).Conclusion All the three treatments have a tendency to improve the clinical outcome of patients with RIF,in which the sequential implantation can not only significantly improve the clinical pregnancy rate of patients with RIF,but also has the lowest risk of twin pregnancy in the four groups.

关 键 词：反复移植失败 HGC宫腔灌注 序贯移植 内膜搔刮 

分 类 号：R714.8[医药卫生—妇产科学]