两种内膜准备方案对宫腔粘连术后患者冷冻胚胎移植妊娠结局的影响  

Effects of two endometrial preparation regimens on pregnancy outcomes of frozen embryo transfer in postoperative patients with uterine adhesions

作　　者：匡云琪 肖彭莹[2] 张若鹏 KUANG Yunqi;XIAO Pengying;ZHANG Ruopeng(School of Clinical Medicine,Dali University,Yunnan,Dali 671000,China;Center for Reproductive Medicine,Maternal and Child Health Hospital of Kunming,Yunnan,Kunming 650118,China)

机构地区：[1]大理大学临床医学院,云南大理671000 [2]昆明市妇幼保健院生殖医学中心,云南昆明650118

出　　处：《中国医药科学》2024年第22期4-7,共4页China Medicine And Pharmacy

基　　金：国家自然科学基金(82260309);云南省第一人民医院临床医学中心开放项目(2022LCZXKF-SZ13)。

摘　　要：目的比较激素替代治疗(HRT)方案和促排卵(OI)方案对宫腔粘连(IUA)术后患者冷冻胚胎移植妊娠结局的影响。方法选取2021年1月至2022年12月在昆明市妇幼保健院生殖医学中心行冷冻胚胎移植的IUA术后患者102例,根据妊娠结局分为活产组(39例)和非活产组(63例),比较两组患者的临床资料及不同内膜准备方案之间的差异,并对影响妊娠结局的因素进一步行logistic回归分析。结果两组年龄、体重指数(BMI)、基础激素水平[卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))]、移植胚胎数、优质胚胎数比较,差异无统计学意义(P>0.05);活产组的不孕年限小于非活产组,转化日子宫内膜厚度大于非活产组,且应用OI方案比HRT方案更容易获得高的活产率,差异有统计学意义(P<0.05)。logistic回归分析显示,转化日内膜厚度是影响活产的独立保护因素(P<0.001);应用HRT方案是独立危险因素(P<0.05)。结论在IUA术后行冷冻胚胎移植的患者中,转化日内膜厚度与不同内膜准备方案均能影响妊娠结局,且OI方案在改善妊娠结局方面优于HRT方案。Objective To compare the effects of hormone replacement therapy(HRT)regimen and ovulation induction(OI)regimen on pregnancy outcomes of frozen-thawed embryo transfer in patients after surgery for intrauterine adhesions(IUA).Methods A total of 102 postoperative IUA patients who underwent frozen-thawed embryo transfer in the Center of Reproductive Medicine of Maternal and Child Health Hospital of Kunming from January 2021 to December 2022 were selected.They divided into the live birth group(n=39)and the non-live birth group(n=63)according to the pregnancy outcome.Clinical data of patients in the two groups and differences between the two endometrial preparation regimens were compared.Logistic regression analysis was further performed on factors affecting the pregnancy outcome.Results Comparison of age,body mass index(BMI),basal hormone levels(follicle-stimulating hormone[FSH],luteinizing hormone[LH],and estradiol[E_(2)]),the number of embryos transferred,and the number of high qualified embryos between the two groups showed no statistically significant difference(P>0.05).The number of years of infertility was less,and the endometrial thickness on the day of conversion was greater in the live birth group than those in the non-live birth group,and the application of the OI regimen was more likely to result in a high live birth rate than that of the HRT regimen,with statistically significant differences(P<0.05).Logistic regression analysis showed that endometrial thickness on the day of conversion was an independent protective factor for live birth(P<0.001).The application of HRT regimen was an independent risk factor(P<0.05).Conclusion In patients undergoing frozen-thawed embryo transfer after IUA,both the endometrial thickness on the day of conversion and different endometrial preparation regimens can affect pregnancy outcomes.The OI regimen is superior to the HRT regimen in improving pregnancy outcomes.

关 键 词：宫腔粘连 冷冻胚胎移植 激素替代治疗方案 促排卵方案 

分 类 号：R714.8[医药卫生—妇产科学]