摘要
目的 探讨接受冻胚移植(FET)患者移植前1日雌二醇(E2)浓度变化对妊娠结局的影响.方法 选取360例接受FET助孕治疗且内膜准备方案为自然周期方案(NC)及激素替代周期方案(HRT)的不孕患者作为研究对象,根据移植前1日E2浓度的变化分为3组.A组244例,移植前1日E2≥100 pg/mL;B组48例,移植前1日E2＜100 pg/mL;C组68例,移植前1日E2＜100pg/mL+注射人绒毛膜促性腺激素(HCG).随访并分析3组患者的一般资料、临床特征、妊娠结局.结果 3组患者的一般资料差异无统计学意义(P＞0.05),妊娠结局中,3组患者的生化妊娠率分别为3.28％、2.08％、4.41％;早期流产率分别为18.02％、22.22％、13.79％;多胎妊娠率分别为10.81％、22.22％、3.44％,差异均无统计学意义(P＞0.05).3组患者的临床妊娠率分别为45.49％、18.75％、42.65％;活产率分别为 37.29％、14.58％、36.76％,差异有统计学意义(P＜0.05).NC 方案中,3组患者的临床妊娠率分别为49.18％、19.05％、47.73％,差异有统计学意义(P＜0.05).HRT方案中,3组患者的临床妊娠率分别为44.26％、18.52％、33.33％,差异有统计学意义(P＜0.05).结论 移植前1日雌二醇(E2)浓度变化与临床妊娠率呈显著相关,对于接受FET且E2＜100 pg/mL的患者,内膜准备时添加小剂量的人绒毛膜促性腺激素(HCG)可以提高临床妊娠率,FET内膜准备时NC方案和HRT方案对妊娠结局没有影响.
Abstract
Objective To explore the impact of changes in estradiol(E2)concentration on pregnancy outcomes in patients un-dergoing frozen embryo transfer(FET)on the first day before transplantation.Methods A total of 360 infertile patients who received FET assisted pregnancy treatment with natural cycle(NC)and hormone replacement cycle(HRT)endometrial preparation regimens were se-lected as the study subjects.They were divided into three groups based on the changes in E2 concentration on the day before transplanta-tion.There were 244 cases in group A,with E2≥100 pg/mL on the day before transplantation,48 cases in group B,with E2＜100 pg/mL on the day before transplantation,and 68 cases in group C,with E2＜100 pg/mL+injection of human chorionic gonadotropin(HCG)on the day before transplantation.The general information,clinical characteristics,and pregnancy outcomes of three groups of patients were fol-lowed up and analyzed.Results There was no statistically significant difference in general information among the three groups(P＞0.05).In terms of pregnancy outcomes,the biochemical pregnancy rates of the three groups were 3.28％,2.08％,and 4.41％,respec-tively.The early miscarriage rates were 18.02％,22.22％and 13.79％,respectively.The multiple pregnancy rates were 10.81％,22.22％,and 3.44％,respectively,and the differences were not statistically significant(P＞0.05).The clinical pregnancy rates of the three groups were 45.49％,18.75％,and 42.65％,respectively.The live birth rates were 37.29％,14.58％,and 36.76％,respective-ly,with statistically significant differences(P＜0.05).In the NC protocol,the clinical pregnancy rates of the three groups were 49.18％,19.05％,and 47.73％,respectively,with statistically significant differences(P＜0.05).In the HRT regimen,the clinical pregnancy rates of the three groups of patients were 44.26％,18.52％,and 33.33％,respectively,with statistically significant differences(P＜0.05).Conclusion The change in estrogen(E2)concentration on the day before transplantation is significantly correlated with clinical pregnancy rate.For patients receiving FET with E2＜100 pg/mL,adding a small dose of human chorionic gonadotropin(HCG)during endometrial preparation can improve clinical pregnancy rate.NC and HRT regimens during FET endometrial preparation have no effect on pregnancy outcome.
基金项目
国家重点研发计划(2021YFC2700401)
宁夏回族自治区科技惠民项目(2022CMG03018)
维普
万方数据