探讨两种治疗方法对薄型子宫内膜冻融胚胎移植助孕结局的影响。
对2018年1月至2019年12月在河北医科大学第二医院生殖医学中心治疗的66例第一周期失败患者进行回顾性研究。一组(n=25)通过腔内输注使用粒细胞集落刺激因子(G-CSF),该组(n=41)皮下注射生长激素(GH)。比较两组患者的临床资料,包括子宫内膜的形态和厚度,生化妊娠率,临床妊娠率,植入率,流产率,和活产率在激素替代周期的每个时期。
年龄没有显著差异,BMI,AMH,FSH,LH,E2,不孕年限,移植的胚胎数量,基底子宫内膜,P给药当天治疗前后子宫内膜厚度(P>0.05)。治疗后,与GH组相比,G-CSF组的生化妊娠率较高(56%对48.8%;P=0.569),临床妊娠率(52%对46.3%;P=0.655),种植率(34.8%对27.5%;P=0.391),和活产率(40%对31.7%;P=0.493),但差异无统计学意义(P>0.05)。在治疗的第5天,G-CSF组子宫内膜厚度较GH组薄(4.83±0.85vs5.75±1.27;P<0.05),但与妊娠结局无相关性(P>0.05)。两组7日子宫内膜厚度无明显差异,治疗第9天和给药第9天(P>0.05)。在治疗的第5天,GH组A型子宫内膜形态比例明显高于G-CSF组(P<0.05),G-CSF组B型形态明显高于GH组(P<0.05)。
虽然G-CSF和GH在增加子宫内膜中可能没有作用,两者均能改善子宫内膜薄型患者FET周期的妊娠结局。两种处理的效果相似。
To investigate the effect of two treatments on the outcome of freeze-thaw embryo transfer for pregnancy assistance in thin endometrium.
A retrospective study was conducted on 66 patients who failed in the first cycle treated in the reproductive medicine center of the Second Hospital of Hebei Medical University from January 2018 to December 2019. Granulocyte colony stimulating factor (G-CSF) was used through cavity infusion in one group (n=25, and growth hormone (GH) was subcutaneously injected in the group (n=41). The clinical data of the two groups were compared, including morphology and thickness of the endometrium, biochemical pregnancy rate, clinical pregnancy rate, implantation rate, miscarriage rate, and live birth rate in each period of the hormone replacement cycle.
There was no significant difference in age, BMI, AMH, FSH, LH, E2, infertility years, number of transferred embryos, basal endometrium, and thickness of endometrium on the day of P administration before and after treatment (P> 0.05). After treatment, compared to the GH group, the G-CSF group presented higher biochemical pregnancy rate (56% versus 48.8%; P=0.569), clinical pregnancy rate (52% versus 46.3%; P=0.655), implantation rate (34.8% versus 27.5%; P=0.391), and live birth rate (40% versus 31.7%; P=0.493), but the differences were not statistically significant (P > 0.05). On the 5th day of treatment, the endometrial thickness in the G-CSF group was thinner than that in the GH group (4.83 ± 0.85 versus 5.75 ± 1.27; P< 0.05), but it had no correlation with pregnancy outcome (P > 0.05). There was no significant difference in endometrial thickness between the two groups on the 7th, 9th day of treatment and the day of P administration (P > 0.05). On the 5th day of treatment, the proportion of endometrial type A morphology in the GH group was significantly higher than that in the G-CSF group (P < 0.05), while the type B morphology in the G-CSF group was significantly higher than that in the GH group (P< 0.05).
Although G-CSF and GH may not have a role in increasing endometrium, both of them can improve the pregnancy outcomes of patients with thin endometrium in the FET cycle. And the effects of the two treatments were similar.