宫腔镜子宫内膜微刺激术后再次冻融胚胎移植的临床结局

发布时间：2019-05-24 06:05

【摘要】：目的探讨宫腔镜子宫内膜微刺激术对再次移植冻融胚胎患者临床结局的影响。方法选取2015年1月—2016年8月在本院行体外受精(IVF)助孕首次移植治疗失败的患者共281例,随机分为研究组(A组)和对照组(B组)。A组129例,月经干净后第3~7日进行宫腔镜子宫内膜微刺激术;B组152例,第2次移植前未行手术。统计分析冻融胚胎移植(FET)的妊娠结局。结果 (1)A、B两组间患者年龄、不孕年限、基础性激素、体质量指数、黄体酮转化日内膜厚度、移植胚胎数、优质胚胎率、异位妊娠率、多胎率、早期流产率相比较,差异无统计学意义(P0.05)。(2)A组的临床妊娠率和着床率分别是58.1%、34.0%,显著高于B组(47.4%、27.6%)(P0.05)。进一步运用多因素Logistic回归分析显示,宫腔镜子宫内膜微刺激术能够显著增加临床妊娠的几率(OR=1.50,95%CI=1.12~2.43),而对异位妊娠、多胎妊娠及早期流产的发生无明显影响。结论宫腔镜子宫内膜微刺激术属微创手术、并发症少,手术方便快捷,能更直观评价患者的宫腔内情况,并且通过对子宫内膜局部轻微刺激,改善内膜容受性,提高着床率、妊娠率,故宫腔镜子宫内膜微刺激术值得推广。
[Abstract]:Objective to investigate the effect of hysteroscopic endometrial microstimulation on the clinical outcome of retransfer of frozen-thawed embryos. Methods A total of 281 patients who failed to be treated with (IVF) assisted pregnancy in vitro from January 2015 to August 2016 were randomly divided into study group (group A) and control group (group B,). A group, n = 129). Hysteroscopy was performed on the 3rd to 7th day after menstruation was clean. In group B, 152 cases were not operated before the second transplantation. The pregnancy outcome of freeze-thawed embryo transfer (FET) was statistically analyzed. Results (1) the age, infertile age, basic hormone, body mass index, intimal thickness of progesterone conversion day, number of embryos transferred, high quality embryo rate, ectopic pregnancy rate, multiple pregnancy rate and early abortion rate were compared between group B and group B, and the number of embryos transferred was compared with that of high quality embryo rate, ectopic pregnancy rate, multiple pregnancy rate and early abortion rate. There was no significant difference (P 0.05). (2). The clinical pregnancy rate and implantation rate in group A were 58.1% and 34.0%, respectively, which were significantly higher than those in group B (47.4%, 27.6%) (P 0.05). Furthermore, multivariate Logistic regression analysis showed that hysteroscopic intimal microstimulation could significantly increase the probability of clinical pregnancy (OR=1.50,95%CI=1.12~2.43), but had no significant effect on ectopic pregnancy, multiple pregnancy and early abortion. Conclusion hysteroscopic intimal microstimulation is a minimally invasive operation with fewer complications and convenient and rapid operation. It can more intuitively evaluate the intrauterine condition of the patients, and improve the intimal receptivity and implantation rate by slightly stimulating the intima. Pregnancy rate, hysteroscopic microstimulation of the uterus is worth popularizing.
【作者单位】：中国人民解放军武汉总医院生殖医学中心;
【基金】：吴阶平医学基金会临床科研专项基金资助(320.6755.15032)~~
【分类号】：R714.8

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