惰性宫内节育器对薄型子宫内膜的影响

摘要

Objective To study whether inert IUD (intrauterine device)can improve the endometrial receptivity of the thin endometrium.Methods Sixty-five patients from People's Hospital of Luohu District from Jan.2011 to Jun.2012 who cancelled the fresh cycle because of the endometrial thickness less than 6mm(injection of human chorionic gonadotropin and transplant day),and failed after conventional treatment including long-term controlled ovarian hyperstimulation treatment,in vitro fertilization-embryo transfer(IVF-ET) or oval intracytoplasmic sperm injection(ICSI) assisted reproduction were selected.Defrosting cycles conventional treatment methods include:supplemental estrogen,ovulation and vaginal sildenafil citrate,etc..After excluding organic disease by hyseroscopy,inert IUD was placed in and the ring was taken out after three months.Before and after IUD endometrial thickness and blood flows (i.e.whether endometrial blood flow,subendocardial blood flow exists).Results No significant difference was detected in the endometrial thickness before and after IUD (P ＞ 0.05),but the blood flows was significantly better(P ＜ 0.05).Conclusion Placing inert IUD for short term can improve the endometrial receptivity to achieve the aim of pregnancy,which provides a new way for the patients.%目的 探讨放置惰性宫内节育器(IUD)能否改善薄型子宫内膜的容受性.方法 选择自2011年1月至2012年6月深圳市罗湖医院生殖中心采用长方案控制性超促排卵治疗,体外受精-胚胎移植(IVF-ET)或卵胞质内单精子显微注射助孕,因子宫内膜薄放弃新鲜移植,拟解冻周期移植时按常规方法治疗子宫内膜厚度无改善的患者65例.注射绒毛膜促性腺激素(HCG)当日及移植日子宫内膜厚度≤6 mm,解冻周期时常规治疗方法包括:雌激素补充、促排卵及阴道用枸橼酸西地那非等,子宫内膜厚度无改善,宫腔镜排除宫腔内器质性病变后放置惰性IUD 3个月,然后取环.上环前后分别B超监测:①检查子宫内膜厚度；②子宫内膜血流情况(即内膜血流、内膜下血流是否存在).结果 上环前后子宫内膜厚度无明显改变(P＞0.05),但子宫内膜血流明显改善(P＜0.05),具有显著性差异.结论 短期放置惰性IUD可能能够改善此类患者子宫内膜容受性,从而达到妊娠的目的,为改善此类患者的子宫内膜容受性提供了新的途径.