宫腔灌注粒细胞集落刺激因子对薄型子宫内膜患者冻融胚胎移植妊娠结局的影响  

Effect of intrauterine perfusion of granulocyte-colony stimulating factor on pregnancy outcome of patients with thin endometrium undergoing frozen-thawed embryo transfer

作　　者：陈丽芬 周媛萍 董其音 曹单 CHEN Lifen;ZHOU Yuanping;DONG Qiyin;CAO Dan(Authors'address:Department of Reproductive Medical Center,Huzhou Maternity&Child Health Care Hospital,Huzhou 313000,China)

机构地区：[1]湖州市妇幼保健院生殖医学中心,313000

出　　处：《浙江医学》2024年第15期1607-1612,共6页Zhejiang Medical Journal

基　　金：湖州市科学技术局公益性应用研究项目(2023GYB36、2021GYB28)。

摘　　要：目的探讨粒细胞集落刺激因子(G-CSF)宫腔灌注治疗对薄型子宫内膜患者冻融胚胎移植妊娠结局的影响。方法回顾性选取2017年1月至2023年10月在湖州市妇幼保健院生殖医学中心接受冻融胚胎移植助孕,既往控制性卵巢刺激周期中因子宫内膜厚度未达标取消新鲜胚胎移植,予大剂量雌激素治疗后子宫内膜厚度<7 mm的薄型子宫内膜患者132例。其中76例患者接受宫腔灌注G-CSF治疗(G-CSF组),另56例患者未接受宫腔灌注G-CSF治疗(对照组)。比较GCSF组患者宫腔灌注治疗前后子宫内膜厚度;比较两组患者妊娠结局,并采用多因素修正泊松回归分析患者临床妊娠的影响因素。结果G-CSF组患者宫腔灌注治疗后子宫内膜厚度大于治疗前[(7.6±0.9)mm比(5.4±0.9)mm,P<0.05]。G-CSF组胚胎种植率、临床妊娠率均高于对照组(40.0%比30.3%、52.6%比33.9%,均P<0.05),早期流产率呈下降趋势,两组患者早期流产率比较差异无统计学意义(25.0%比31.6%,P>0.05)。多因素修正泊松回归分析显示,调整混杂因素后,G-CSF宫腔灌注不是薄型子宫内膜患者临床妊娠的影响因素(RR=1.217,95%CI:0.615~2.410,P>0.05)。结论薄型子宫内膜患者冻融胚胎移植内膜准备时可考虑行G-CSF宫腔灌注治疗,增加子宫内膜厚度,以提升临床妊娠率、胚胎种植率。Objective To investigate the effect of intrauterine perfusion with granulocyte colony-stimulating factor(G-CSF)on pregnancy outcomes in women with thin endometrium undergoing frozen-thawed embryo transfer(FET).Methods In this retrospective cohort study,132 women with thin endometrium undergoing frozen-thawed embryo transfer cycles in Reproductive Medicine Center of Huzhou Maternity&Child Health Care Hospital from January 2017 to October 2023 were enrolled,including 76 cases receiving intrauterine infusion of G-CSF before the day of administration of progesterone(G-CSF group),and 56 patients without G-CSF treatment(control group).The general data of patients and pregnancy outcome of FET were compared between the two groups;endometrial thickness was compared before and after intrauterine perfusion;and multivariate modified Poisson regression was used to analyze the influencing factors of clinical pregnancy.Results In G-CSF group,the endometrial thickness was significantly increased from(5.4±0.9)mm to(7.6±0.9)mm(P<0.05)after G-CSF perfusion.The embryo implantation rate and clinical pregnancy rate in the G-CSF group were significantly higher than those in the control group(40.0%vs.30.3%,52.6%vs.33.9%,both P<0.05);and the early miscarriage rate was on a downward trend,but there was no statistical difference between the two groups(25.0%vs.31.6%,P>0.05).Multivariate modified Poisson regression analysis suggested that the intrauterine perfusion of G-CSF had no significant impact on clinical pregnancy rate after adjusting confounding factors(RR=1.217,95%CI:0.615-2.410,P>0.05).Conclusion In patients with thin endometrium,intrauterine perfusion of G-CSF can be considered to increase the endometrium thickness for FET to improve the clinical pregnancy rate and implantation rate.

关 键 词：粒细胞集落刺激因子 薄型子宫内膜 临床妊娠率 胚胎种植率 早期流产率 

分 类 号：R714.8[医药卫生—妇产科学]