降调节联合激素替代周期方案在多次胚胎种植失败患者冻融胚胎移植周期中的应用

发布时间：2018-08-25 10:46

【摘要】：目的探讨多次胚胎种植失败的患者行降调节联合激素替代周期方案对冻融胚胎移植妊娠结局的影响。方法回顾性分析2013年12月至2014年12月在首都医科大学附属北京妇产医院生殖中心接受冻融胚胎移植且既往胚胎种植失败次数≥2次的患者共174例。根据本次冷冻移植周期子宫内膜准备方法分为2组:其中A组采用促性腺激素释放激素-激动剂(gonadotrophin-releasing hormone agonist,GnRHa)降调节联合激素替代周期(hormone replacement therapy,HRT)方案(n=78),B组采用单纯激素替代周期方案(n=96),分析2种内膜准备方案对患者妊娠结局的影响。结果 2组患者的不孕年限、年龄、体质量指数、基础内分泌激素浓度;移植胚胎数、优质胚胎数、胚胎复苏率、黄体酮转化日子宫内膜厚度;胚胎种植率(22.8%vs19.8%)、临床妊娠率(42.3%vs 37.5%)、早期流产率(9.1%vs 11.1%)比较,差异均无统计学意义(P0.05)。结论对多次胚胎种植失败的患者,GnRHa降调节联合激素替代方案在胚胎着床率和临床妊娠率方面较单纯激素替代周期方案有升高趋势,但差异无统计学意义(P0.05),有待于进一步扩大样本量研究。
[Abstract]:Objective to investigate the effect of multiple failed embryo implantation combined with hormone replacement cycle on the pregnancy outcome of freeze-thawed embryo transfer. Methods from December 2013 to December 2014, 174 patients received frozen-thawed embryo transfer at the Reproductive Center of Beijing Maternity Hospital affiliated to Capital Medical University and the number of previous embryo implantation failures was more than 2 times. According to the method of endometrial preparation during the period of cryopreservation transplantation, group A was divided into two groups: group A was treated with gonadotropin-releasing hormone agonist (gonadotrophin-releasing hormone agonist,GnRHa) and hormone replacement cycle (hormone replacement therapy,HRT) regimen (nb78) and group B was treated with simple hormone replacement. The effect of two kinds of endometrial preparation regimen on pregnancy outcome was analyzed. Results Infertility, age, body mass index, basal endocrine hormone concentration, number of embryos transferred, number of high-quality embryos, rate of embryo resuscitation, thickness of endometrium on the day of progesterone conversion were observed in the two groups. Embryo implantation rate (22.8vs 19.8%), clinical pregnancy rate (42.3%vs 37.5%), early abortion rate (9.1%vs 11.1%), there was no significant difference (P0.05). Conclusion the implantation rate and clinical pregnancy rate of GnRHa combined with hormone replacement regimen in multiple failed embryo implantation patients were higher than those in single hormone replacement cycle regimen. However, the difference was not statistically significant (P0.05), which needed to be further expanded.
【作者单位】：首都医科大学附属北京妇产医院生殖医学科;
【基金】：国家自然科学基金项目(81170542,81471431) 北京市自然科学基金项目(7152055) 首都医科大学附属北京妇产医院学科带头人项目(2013-2)~~
【分类号】：R714.8

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