子宫内膜容受性基因检测技术在反复种植失败患者中的应用及种植窗位移的影响因素分析  

Application of the endometrial receptivity gene detection technology in patients with repeated implantation failure and the analysis of the influencing factors of the implantation window

作　　者：梁静一 李丹丹 李改先 LIANG Jingyi;LI Dandan;LI Gaixian(Hebei Yanda Hospital,Hebei Province,065201)

机构地区：[1]河北燕达医院,065201

出　　处：《中国计划生育学杂志》2025年第4期896-900,共5页Chinese Journal of Family Planning

基　　金：2023年廊坊市科学技术研究与发展计划自筹经费项日(2023013077)。

摘　　要：目的:探讨子宫内膜容受性基因检测(ERT)技术在反复种植失败(RIF)患者中的应用效果,并分析种植窗位移的影响因素。方法:选取2022年1月-2024年1月80例体外受精-胚胎移植(IVF-ET)中RIF患者作为研究对象,其中同意接受ERT技术检测的60例设为ERT组,进一步根据种植窗(WOI)是否位移分为位移组与正常组,不同意接受ERT检测的20例设为常规移植组,比较各组临床妊娠率、胚胎种植率等指标;采用logistic回归分析WOI位移的影响因素。结果:ERT组60例中WOI正常者占41.7%,WOI位移者占58.3%。位移组生化妊娠率、临床妊娠率分别为56.0%、48.0%,正常组分别为51.4%、45.7%,均高于常规移植组的40.0%、30.0%(均P<0.05)。logistic回归分析显示,高卵泡刺激素(FSH)水平、胰岛素抵抗是RIF患者种植窗位移的危险因素(OR=1.426,95%CI 1.327~2.725;OR=1.503,95%CI 1.263~2.738)。结论:采用ERT技术可根据RIF患者的种植窗调整冻融胚胎移植时间,提高临床妊娠率。高FSH水平、胰岛素抵抗是RIF患者种植窗位移的危险因素。Objective:To evaluate the effect of the endometrial receptivity gene testing(ERT)technology in patients with repeated implantation failure(RIF),and to analyze the influencing factors of the implant window of the patients.Methods:A total of 80 patients with RIF who had been given in vitro fertilization-embryo transfer(IVF-ET)from January 2022 to January 2024 were selected as the study objects.Among them,60 patients who agreed to be tested by ERT were included in study group and were further divided into group A(patients with the displaced implant window)and group B(patients with the normal implant window)according to whether the window of implantation(WOI)displaced or not.Another 20 patients who did not agree to receive ERT were included in control group.The clinical pregnant rate and the embryo implantation rate of the patients were compared among these groups.The influencing factors of the displacement of WOI of the patients were analyzed by logistic regression.Results:Of the 60 patients in the study group,there were 41.7%in group B and 58.3%of the patients in group A.The biochemical pregnancy rate and the clinical pregnancy rate of the patients in group A were 56.0%and 48.0%,and those of the patients in group B were 51.4%and 45.7%,and which of the patients in both group A and group B were significantly higher than those(40.0%and 30.0%)of the patients in the control group(all P<0.05).Logistic regression analysis showed that the high FSH level(OR=1.426,95%CI 1.327-2.725)and the insulin resistance(OR=1.503,95%CI 1.263-2.738)of the patients with RIF during IVF-ET were the risk factors of their displaced WOI.Conclusion:ERT technique can guide the time of the freeze-thaw embryo transfer(FET)of the patients with RIF according to their WOI,and which can improve the clinical pregnancy rate of these patients.The high FSH level and the insulin resistance of the patients with RIF are the risk factors of their displaced WOI.

关 键 词：子宫内膜容受性基因检测 反复种植失败 临床妊娠率 种植窗位移 影响因素 

分 类 号：R711.6[医药卫生—妇产科学]