低分子肝素与生长激素对反复种植失败者的应用效果比较
发布时间：2018-12-13 00:27
【摘要】：目的探讨低分子肝素(LMWH)、生长激素(GH)应用于反复种植失败(RIF)患者再次行体外受精-胚胎移植助孕时,对其助孕过程及妊娠结局有无影响,并对比其应用效果。方法本研究采用前瞻性的研究方法,对2015年6月~2017年2月就诊于唐山市妇幼保健院生殖遗传科多次(≥3个周期,包括解冻周期)行体外受精胚胎移植失败而再次行新鲜周期胚胎移植的不孕患者124周期进行研究。随机将符合条件的研究对象分为常规组42周期、LMWH组41周期、GH组41周期。比较各组获卵数、MII数、优质胚胎数、优质胚胎率;比较HCG日内膜厚度及A/B型内膜比例;比较生化妊娠率、胚胎种植率、临床妊娠率。并比较三组患者中年龄35岁的周期、≥35岁的周期分别所对应的妊娠结局;比较三组患者中考虑无血栓前状态的周期、有血栓前状态的周期分别所对应的妊娠结局,以探究LMWH、GH在RIF患者中的应用价值并比较两药效果的差异性。结果1三组患者的年龄、不孕年限、BMI、AFC、bFSH、bE2、血栓前状态率比相比较无统计学差异(P0.05);三组患者的促排卵情况中Gn天数、Gn用量、HCG日E2对比无统计学差异(P0.05);三组患者胚胎情况中的获卵数、MII卵数、优质胚胎数、优质胚胎率相比无统计学差异(P0.05);三组患者的凝血系列TT、APTT、PT、FIB及D-二聚体(D-Di)相比无统计学差异(P0.05)。2三组患者HCG日内膜厚度、A/B型内膜比例无统计学差异(P0.05)。3 LMWH组的生化妊娠率相较于常规组明显增高,差异有统计学意义(P0.017),LMWH组的生化妊娠率与GH组相比较,差异无统计学意义(P0.017),常规组的生化妊娠率相较于GH组差异无统计学意义(P0.017);三组患者的胚胎种植率、临床妊娠率差异无统计学意义(P0.05)。4三组患者中年龄35岁的周期,其胚胎种植率、临床妊娠率均无显著性差异(P0.05),三组患者中年龄≥35岁的周期其胚胎种植率、临床妊娠率有所升高,但无显著性差异(P0.05)。5三组中考虑无血栓前状态的周期,其组间的胚胎种植率、临床妊娠率均无显著性差异(P0.05);三组中考虑为血栓前状态的周期,三组间胚胎种植率无显著差异(P0.05),LMWH组的临床妊娠率相较于常规组明显增高,差异具有显著性(P0.017),LMWH组的临床妊娠率相较于GH组相比较无显著性差异(P0.017),常规组与GH组的临床妊娠率相比较无显著性差异(P0.017)。结论1低分子肝素对于有血栓前状态的RIF患者有明显的助孕益处,可提高其临床妊娠率,应用具有安全性,可考虑作为具有高凝状态反复种植失败者的辅助用药。2生长激素对于病因欠确切的RIF患者受益或并不明显。3反复种植失败的病因复杂,加强病因学筛查的同时,用药的选择也应强调个体化。
[Abstract]:Objective to investigate the effect of low molecular weight heparin (LMWH) (LMWH), growth hormone (GH) (LMWH (GH) on the pregnancy aid process and pregnancy outcome in patients with repeated failed (RIF) during in vitro fertilization and embryo transfer (IVF). Methods in this study, prospective research methods were used to study the reproductive genetics department of Tangshan Maternal and Child Health Hospital from June 2015 to February 2017. The study was conducted on 124 cycles of infertile patients undergoing in vitro fertilization and embryo transfer, including thawing cycles, and repeated fresh cycle embryo transfer. The subjects were randomly divided into normal group (42 cycles), LMWH group (41 cycles) and GH group (41 cycles). The number of eggs, MII, the rate of high quality embryos, the thickness of intima and the ratio of type A / B intima of HCG, the rate of biochemical pregnancy, the rate of embryo implantation and the rate of clinical pregnancy were compared. The pregnancy outcomes of the three groups were compared between the cycles of 35 years old and the cycles of 鈮，
本文编号：2375517
[Abstract]:Objective to investigate the effect of low molecular weight heparin (LMWH) (LMWH), growth hormone (GH) (LMWH (GH) on the pregnancy aid process and pregnancy outcome in patients with repeated failed (RIF) during in vitro fertilization and embryo transfer (IVF). Methods in this study, prospective research methods were used to study the reproductive genetics department of Tangshan Maternal and Child Health Hospital from June 2015 to February 2017. The study was conducted on 124 cycles of infertile patients undergoing in vitro fertilization and embryo transfer, including thawing cycles, and repeated fresh cycle embryo transfer. The subjects were randomly divided into normal group (42 cycles), LMWH group (41 cycles) and GH group (41 cycles). The number of eggs, MII, the rate of high quality embryos, the thickness of intima and the ratio of type A / B intima of HCG, the rate of biochemical pregnancy, the rate of embryo implantation and the rate of clinical pregnancy were compared. The pregnancy outcomes of the three groups were compared between the cycles of 35 years old and the cycles of 鈮，
本文编号：2375517
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