目的 探讨生长激素(GH)宫腔灌注联合激素替代周期(HRT)在冻融胚胎移植(FET)中治疗无反应型薄型子宫内膜的疗效.方法 前瞻性选择2014年6月至12月湖南省妇幼保健院生殖中心行FET且无反应性薄型子宫内膜患者5例,应用GH宫腔灌注联合HRT进行FET.结果 5例患者在HRT备膜基础上均接受4～5次GH宫腔灌注治疗,与自身比较,GH宫腔灌注后黄体酮日子宫内膜厚度[(7.96 ±0.71)mm]显著大于首次灌注子宫内膜厚度[(5.78 ±0.65) mm],增加其厚度(2.18 ±0.47)mm,其差异有统计学意义(t=10.46,P＜0.01);其移植日子宫内膜厚度均＞7mm.5例患者获得临床妊娠,胚胎种植率72.73％(8/11).结论 GH宫腔灌注联合HRT在FET中治疗无反应性薄型子宫内膜有一定疗效,既可增加其子宫内膜厚度,又能改善内膜容受性,有利于提高冻胚种植率和临床妊娠率.%Objective To assess the efficacy of growth hormone(GH) intrauterine administration combined with hormone replacement cycle (HRT) in frozen-thawed embryo transfer (FET) cycles for unresponsive thin endometrium.Methods Prospective cohort study of five consecutive women undergoing invitro fertilization (IVF) who,after standard endometrial preparation,still demonstrated highly inadequate endometrium.They all accepted transvaginal endometrial perfusion with GH in FET cycles.Results Five patients with unresponsive thin endometrium accepted four or five GH intrauterine administrations during FET cycles.The average endometrial expansion at endometrial conversion date was (2.18 ±0.47) mm,from (5.78 ±0.65) mm to (7.96 ±0.71) mm.Successful endometrial expansion to at least minimal thickness of 7 mm after uterine perfusion with GH in five patients previously resistant to treatment with estrogen.All five patients therefore reached FET,and all five also conceived,and embryo implantation rate was 72.73％ (8/11).Conclusions Uterine perfusion with GH combined with HRT represents a promising new treatment for the unresponsive thin endometrium patients in FET.This treatment also deserves further investigation for its potential to improve implantation chances in association with assisted reproduction.
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