摘要
目的探讨既往多次种植失败患者行激素替代治疗不同内膜准备方案、雌二醇总用药时间及孕酮日内膜厚度对冻胚移植妊娠结局的影响。方法回顾性分析2017年l月-2018年5月既往胚胎种植失败≥2次患者采用激素替代治疗行子宫内膜准备的冻胚移植共285周期。患者根据用药方案不同分为A、B两组。A组单纯口服戊酸雌二醇方案准备内膜,B组口服戊酸雌二醇联合阴塞微粒化17β-雌二醇改良方案准备内膜,探讨不同内膜准备方案对内膜厚度及冻胚移植妊娠结局的影响。进一步根据雌二醇总用药时间及孕酮日内膜厚度进行分组,探讨不同用药时间及内膜厚度对冻胚移植妊娠结局的影响。结果B组孕酮日血清雌二醇水平、临床妊娠率及分娩率明显高于A组(t=-14.575,χ^2=5.972、6.322,P<0.05)。雌二醇总用药时间≥16 d组孕酮日内膜厚度明显小于7~10 d组和11~15 d组(F=9.549,P<0.05)。孕酮日内膜厚度>10 mm组胚胎种植率、临床妊娠率及分娩率较孕酮日内膜厚度≤10 mm组明显增高(χ^2=4.042~7.234,P<0.05)。结论口服戊酸雌二醇联合阴塞微粒化17β-雌二醇改良方案能够改善多次种植失败患者的妊娠结局。
Objective To investigate the effect of different endometrial preparation protocols,estradiol duration,and endometrial thickness on the day of using progesterone on the pregnancy outcome of frozen embryo transfer in patients with repeated implantation failure receiving hormone replacement therapy.Methods A retrospective analysis was performed for 285 hormone replacement cycles for endometrial preparation in frozen embryo transfer in the patients with repeated implantation failure for≥2 times from January 2017 to May 2018.According to the endometrial preparation protocol,the patients were divided into groups A and B.The patients in group A were given estradiol valerate alone for endometrial preparation,and those in group B were given the modified regimen of estradiol valerate combined with micronized 17β-estradiol transvaginal suppository.The effect of different endometrial preparation protocols on endometrial thickness and pregnancy outcome of frozen embryo transfer was analyzed.The patients were divided into groups according to estradiol duration and endometrial thickness on the day of using progesterone to investigate their effect on the pregnancy outcome of frozen embryo transfer.Results Compared with group A,group B had significantly higher estradiol concentration on the day of using progesterone,clinical pregnancy rate,and parturition rate(t=-14.575,χ^2=5.972,6.322,P<0.05).The patients with an estradiol duration of≥16 days had a significantly lower endometrial thickness on the day of using progesterone than those with an estrogen duration of 7-10 days or 11-15 days(F=9.549,P<0.05).The patients with an endometrial thickness of>10 mm on the day of using progesterone had significantly higher embryo implantation rate,cli-nical pregnancy rate,and parturition rate than those with an endometrial thickness of≤10 mm(χ^2=4.042-7.234,P<0.05).Conclusion The modified regimen of oral estradiol valerate combined with micronized 17β-estradiol transvaginal suppository can improve pregnancy outcome in patients with repeated implantation failure.
作者
刘梦瑶
郑烨
田泉
曹阳
刘建新
LIU Mengyao;ZHENG Ye;TIAN Quan;CAO Yang;LIU Jianxin(Department of Reproductive Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266003, China)
出处
《精准医学杂志》
2020年第3期241-244,共4页
Journal of Precision Medicine
基金
山东省自然科学基金资助项目(ZR2019BC028)。
关键词
激素替代疗法
胚胎移植
治疗失败
治疗学
雌二醇
妊娠结局
子宫内膜
Hormone replacement therapy
Embryo transfer
Treatment failure
Therapeutics
Estradiol
Pregnancy outcome
Endometrium
作者简介
通讯作者:刘建新,Email:liujianxinlr@126.com。
