他莫昔芬用于薄型子宫内膜患者冻融胚胎移植时子宫内膜准备的研究

发布时间：2018-03-15 08:56

本文选题：他莫昔芬　切入点：薄型子宫内膜　出处：《中国实用妇科与产科杂志》2015年08期 　论文类型：期刊论文

【摘要】：目的探讨他莫昔芬(tamoxifen)方案应用于以往自然周期和激素替代治疗反复出现子宫内膜薄的患者行冻融胚胎移植(FET)时子宫内膜准备的临床效果。方法 2011年11月至2014年4月南方医科大学南方医院妇产科生殖医学中心,回顾性分析61例既往因自然周期和激素替代治疗准备冷冻周期子宫内膜,显示子宫内膜薄而取消移植或者移植后未妊娠患者使用他莫昔芬治疗,观察子宫内膜厚度、性激素水平以及FET后的妊娠结局。结果他莫昔芬周期和既往激素替代治疗周期相比,前者的子宫内膜厚度[(8.8±1.8)mm、(6.5±0.3)mm]和血清雌二醇(E2)水平[(2091.2±1020.5)pmol/L、(969.6±474.2)pmol/L]明显较高,且差异具有统计学意义(P0.05);子宫内膜准备天数明显减少[(13.2±2.9)d、(23.1±4.9)d],差异有统计学意义(P0.05)。他莫昔芬周期的临床妊娠率、早期流产率、胚胎种植率、畸形率分别为44.3%(27/61)、7.4%(2/27)、24.2%(32/132)、0(0/17)。结论对于子宫内膜薄的患者,在冻融胚胎移植周期使用他莫昔芬准备子宫内膜方法简单可行,而且子宫内膜准备时间较短、子宫内膜厚度显著提高,并可获得较满意的妊娠结局。
[Abstract]:Objective to investigate the clinical effect of tamoxifen regimen on endometrial preparation in patients with recurrent endometrial thinness during natural cycle and hormone replacement therapy. Methods from November 2011 to 2014, the clinical effects of tamoxifen regimen on endometrial preparation were investigated. In April, the Center for Gynecology and Obstetrics and Reproductive Medicine, Southern Hospital, Southern Medical University, A retrospective analysis was made on 61 cases of endometrium with cryopreserved cycles due to natural cycle and hormone replacement therapy. The thickness of endometrium was observed by using tamoxifen as a result of canceling transplantation of endometrium or without pregnancy after transplantation. Results compared with the previous hormone replacement therapy cycle, the endometrial thickness of tamoxifen cycle [8.8 卤1.8 mm] and serum estradiol E2 level [2091.2 卤1020.5 渭 mol / L] were significantly higher than those of previous hormone replacement therapy cycle [969.6 卤474.2pmol / L]. The difference was statistically significant (P 0.05), the number of days of endometrial preparation was significantly decreased [13.2 卤2.9 d], the difference was statistically significant (P 0.05). The clinical pregnancy rate, early abortion rate and embryo implantation rate of tamoxifen cycle were significantly different. The rate of malformation is 44.33 / 27 / 71 / 7.40.Conclusion for patients with thin endometrium, it is simple and feasible to use tamoxifen to prepare the endometrium during the period of frozen-thawing embryo transfer, and the preparation time of endometrium is shorter, and the thickness of endometrium is significantly increased. Satisfactory pregnancy outcome can be obtained.
【作者单位】：南方医科大学南方医院妇产科生殖医学中心;
【基金】：广州市科技计划项目重点项目(11C22120737) 国家自然科学基金(81170574) 南方医科大学南方医院高层次匹配课题基金(G201206)
【分类号】：R714.8

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