生殖医学杂志2018，Vol.27Issue(7)：627-631,5.DOI:10.3969/j.issn.1004-3845.2018.07.005
黄体期降调节联合人工周期方案在冻融胚胎反复移植失败患者中的应用
Clinical application of down-regulation in luteal phase combined with artificial cycle scheme in patients with repeated implantation failure of frozen-thawed embryo
摘要
Abstract
Objective:To explore the influences of pre-treatment with 3.75 mg GnRH-a down-regulation in luteal phase on endometrial receptivity and clinical outcomes in patients with repeated implantation failure of frozen-thawed embryo. Methods: The clinical data of 207 patients who accepted FET assisted reproduction technology(ART)with artificial cycle scheme and previously had repeated embryo implantation failures (≥2 times)with 2-3 embryos implantation for each time in our reproductive center from May 2015 to May 2017 were retrospectively analyzed.According to whether or not applying the GnRH-a down-regulation pre-treatment for the endometrium preparation,the patients were divided into down-regulation group(n=118)and non-down-regulation group(n=89) .The gonadal hormone levels,endometrium thickness & blood flow and LH level on the day of inj ecting progesterone,clinical pregnancy rate and abortion rate were compared between the two groups.Forty six patients who were received non-down-regulation artificial cycle protocols for endometrium preparation in the previously cycles were selected for self-control analysis from the down-regulation pretreatment group. Results:The age,infertility duration,basic sex hormone level,endometrial thickness,high-quality embryo rate and early abortion rate had no statistical difference between the two groups(P＞0.05).The proportion of type A blood flow in endometrium [65.17%(58/89)vs.38.98%(46/118)]and clinical pregnancy rate [55.06%(49/89) vs.38.98%(46/118)]in the down-regulation group were significantly higher than non-down-regulation group.LH levels on the day of injecting progesterone in the down-regulation group [(10.27±3.79)vs.(1.89±0.78)U/L] were significantly lower than those the non-down-regulation group(P＜0.05).The self-control analysis showed that endometrial thickness and high-quality embryo rate of patients had no significant difference(P＞0.05).The proportion of type A blood flow after preconditioning [56.52%(26/46)]was significantly higher than the previous non-down-regulation cycle [32.61%(15/46)](P＜0.05). Conclusions:Compared with the traditional artificial cycle scheme for endometrial preparation,pre-treatment with 3.75mg GnRH-a down-regulation can significantly improve endometrial receptivity and clinical pregnancy rate of patients with repeated implantation failure of frozen-thawed embryo,but it does not increase abortion rate.关键词
冻融胚胎/胚胎移植/子宫内膜准备/GnRH-a/妊娠率Key words
Frozen-thawed embryo/Embryo transfer/Endometrial preparation/GnRH-a/Pregnancy rate引用本文复制引用
郝翊,徐野,李建华,魏岩,白杨..黄体期降调节联合人工周期方案在冻融胚胎反复移植失败患者中的应用[J].生殖医学杂志,2018,27(7):627-631,5.基金项目
国家自然科学基金青年项目(81401271) （81401271）
