摘要：
Objective To analyze the mechanical stimulation to the endometrium on the clinical pregnancy rate and embryo implantation rate in the frozen thawed embryo transfer of hormone replacement therapy.Methods There were 193 patients undergoing the frozen thawed embryo transfer of hormone replacement therapy.According to the endometrial condition on the second or third day of the menstrual cycle,they were divided into three groups.Group A,54 patients whose endometrial thickness was no less than 0.6 cm or abnormal endometrium were operated the mechanical stimulation.Group B,55 patients whose endometrial thickness was no less than 0.6 cm or abnormal endometrial were not operated the mechanical stimulation.Group C,84 patients whose endometrial thickness was less than 0.6 cm and normal endometrium.Each group was divided into blastomere transplantation and blastula transplantation.Group A was 23,31 patients,group B was 24,31 patients,group C was 39,45 patients.The age,number of embryo,level of estradiol when injecting chorionic gonadotrophin,clinical pregnancy rate and embryo implantation rate were compared.Results (1) The clinical feature of blastula transplantation.The age,number of embryo,embryo implantation rate among three groups had no significant difference (P ＞ 0.05).The clinical pregnancy rate in group A and group C was significantly higher than that in group B [73.91％ (17/23),69.23％ (27/39)vs.37.50％(9/24)] (P ＜ 0.05),and there was no significant difference between group A and group C (P ＞ 0.05).The level of estradiol when injecting chorionic gonadotrophin in group C was significantly higher than that in group B [(841.56 ± 802.73) μ g/L vs.(293.34 ± 69.14) μ g/L] (P ＜ 0.05).There was no significant difference between group A and group B,group A and group C (P ＞0.05).(2)The clinical feature of blastomere transplantation.The age,number of embryo,level of estradiol when injecting chorionic gonadotrophin,embryo implantation rate and clinical pregnancy rate among three groups had no significant difference (P ＞ 0.05).Conclusions Mechanical stimulation to the endometrium can significantly improve the clinical pregnancy rate of blastula transplantation.It has no improvement for embryo implantation rate and clinical pregnancy rate of blastomere transplantation.%目的 探讨子宫内膜机械性刺激在冻融胚胎移植激素替代周期中对临床妊娠率、胚胎种植率的影响.方法 将193例行激素替代周期冻融胚胎移植患者根据月经第2或3天阴道B超子宫内膜情况分为三组:A组子宫内膜厚度≥0.6 cm或内膜不均匀者采用子宫内膜机械性刺激,54例;B组子宫内膜厚度≥0.6cm或内膜不均匀未行子宫内膜机械性刺激,55例;C组子宫内膜厚度＜0.6cm并且内膜均匀,84例;每组患者各自采用囊胚移植或卵裂球移植(A组分别为23,31例;B组分别为24,31例;C组分别为39,45例).比较三组卵裂球或囊胚移植患者的年龄、移植胚胎数、注射绒促性素日雌二醇、胚胎种植率、临床妊娠等情况.结果 (1)采用囊胚移植患者临床特征比较:三组患者年龄、移植胚胎数、胚胎种植率比较差异无统计学意义(P＞0.05);A组、C组临床妊娠率明显高于B组[73.91％(17/23),69.23％(27/39)比37.50％(9/24)],差异有统计学意义(P＜0.05),A组与C组比较差异无统计学意义(P＞0.05);C组注射绒促性素日雌二醇明显高于B组[(841.56±802.73)μg/L比(293.34 ±69.14) μg/L],差异有统计学意义(P＜0.05),A组与B组、A组与C组比较差异无统计学意义(P＞0.05).(2)采用卵裂球移植患者临床特征比较:三组患者年龄、移植胚胎数、注射绒促性素日雌二醇、胚胎种植率、临床妊娠率比较差异无统计学意义(P＞0.05).结论 子宫内膜机械性刺激可以提高采用囊胚移植的激素替代周期冻融胚胎移植患者的临床妊娠率,而对于卵裂球移植患者的胚胎种植率及临床妊娠率则无改善.
