四种子宫内膜准备方法在玻璃化冻融囊胚移植中的意义

摘要

Objectives:To estimate the clinical value of 4 methods of endometrium preparation for frozen -thawed blastocyst transfer (FET) cycle.Methods:A total of 265 FET cycles completed in Reproductive Center of Guangxi Zhuang Autonmous Region Health and Family Planning Commission from January 2013 to December 2014 were retrospectively analyzed,and divided into four groups:natural cycle group (group NC,n =68),ovulation-inducing cycle group (group OI,n =56),hormone replacement treatment (HRT) cycle group (group HRT,n =108),down-regulated HRT cycle (group G-HRT,n =33).The pregnancy outcomes were followed and compared among these different groups.Results:There were no significant differences in the rates of the clinical pregnancy,implantation,multiple pregnancy biochemical pregnancy,early abortion and ectopic pregnancy rates among the four groups (P ＞ 0.05).However,the rank of the FET cycle of group G-HRT was significantly higher than those of the other three groups (P ＜ 0.05).Conclusion:In FET cycles,the methods of natural cycle,ovulation-inducing,HRT and down-regulated HRT all have favorable clinical outcomes.The method of down-regulated HRT is more suitable for patients with previous implantation failure and individualized method of endometrium preparation should be chosen before FET.%目的:探讨应用四种子宫内膜准备方法在玻璃化冻融囊胚移植中的治疗价值.方法:回顾性分析我中心2014年1月至2014年12月共265个玻璃化冻融囊胚移植周期,按子宫内膜准备方案分组,其中自然周期治疗组有68个周期(NC组),激素替代周期治疗组有108个周期(HRT组),促排卵周期治疗组56个周期(OI组),GnRha后激素替代周期治疗组33个周期(G-HRT组),比较各组妊娠结局.结果:四组患者的临床妊娠率、胚胎种植率、多胎妊娠率、生化妊娠率、流产率以及异位妊娠率比较,差异均无统计学意义(P均＞0.05).G-HRT组FET周期次数显著高于其它三组(P＜0.05).结论:自然周期、促排卵、激素替代和降调后激素替代方案在冻融囊胚移植中均可获得良好的治疗结局.对于反复移植失败患者,降调后激素替代方案有疗效.临床上进行冻融囊胚移植前应选择个体化的子宫内膜准备方法.