【摘要】 目的探讨在冷冻胚胎-解冻移植(冻融胚胎移植,FET)周期中,子宫内膜微刺激术对自然周期患者子宫内膜评价指标及临床妊娠率的影响。方法 2013年1-7月于兰州大学第一医院生殖医学研究中心,前瞻性观察自然周期法实施冷冻胚胎-解冻移植术的不孕症患者591例,采用随机数字表法,将同期符合纳入标准行FET术的患者随机分为两组,分别为内膜刺激组与对照组,其中211例行内膜微刺激术(内膜刺激组),380例为对照组,对比不同时间和次数内膜微刺激对内膜形态特征的改善,分析微刺激术对FET周期治疗结局的影响。结果内膜微刺激术后超声监测HCG日两组子宫内膜厚度差异无统计学意义(P>0.05);与对照组相比,内膜刺激组临床妊娠率差异无统计学意义(P>0.05)。月经期和黄体期行内膜微刺激术两组临床妊娠率分别为60.00%和64.29%(P>0.05);治疗前周期和第二周期移植妊娠率差异均无统计学意义(56.67%vs.60.00%,P>0.05);第1次和第2次行内膜微刺激术后妊娠率为56.67%vs.54.17%(P>0.05)。结论自然周期阴道超声监测子宫内膜提示形态较差的患者经内膜微刺激后可显著改善子宫内膜条件。内膜形态为C型的患者经微刺激后转为A型,可获得与对照组相同的妊娠率。更多还原

【Abstract】 Objective To explore whether endometrial scratching in frozen- thawed embryo transfer cycles(FET) can improve the incidence of clinical pregnancy. Methods Women undergoing FET cycles(n=591) between January and July of 2013 in the First Hospital of Lanzhou University were treated with natural protocol, whose endometrium was diagnosed by B-ultrasound, showing irregular echo. According to random number table, 591 patients were divided into two groups. The endometrial scratching was done in 211 patients, compared with controlled group of 380 patients. The clinical pregnancy and endometrial types for endometrial scratching at different times and numbers were analyzed.Results There was no difference in the thickness of endometrium on the day of HCG administration between groups after the scratching(P>0.05). Compared with control group, there was no statistically significant difference in clinical pregnancy after endometrial scratching in experiment group(P>0.05). The pregnancy rate was 60.00% and 64.29%respectively(P>0.05); there was no difference on the transfer pregnancy rate between before treatment and at the and2 nd stage of transfer(56.67%vs. 60.00%,P>0.05); the rate was 56.67% and 54.17% at the 1st and 2nd time of scratching(P>0.05). Conclusion Endometrial scratching may have a beneficial role in endometrium characteristics and improve the pregnancy rate. However, further study on timing, technique and number of endometrial injury were needed.更多还原