首页|促性腺激素释放激素激动剂对反复种植失败合并慢性子宫内膜炎患者冻融胚胎移植周期妊娠结局的影响

促性腺激素释放激素激动剂对反复种植失败合并慢性子宫内膜炎患者冻融胚胎移植周期妊娠结局的影响

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目的 探讨促性腺激素释放激素激动剂(GnRH-a)对反复种植失败(RIF)合并慢性子宫内膜炎(CE)患者冻融胚胎移植(FET)周期妊娠结局的影响。方法 回顾性纳入2020年1月至2023年12月于首都医科大学附属北京妇产医院生殖医学科进行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)治疗的RIF合并CE患者138例,按照冻融胚胎移植周期内膜准备方法分为两组:降调节人工周期组(n=59)和人工周期组(n=79),比较两组患者的一般资料及妊娠结局。应用多因素logistic回归模型分析RIF合并CE患者获得临床妊娠的影响因素。结果 人工周期组年龄[M(Q1,Q3)]33(31,37)岁;降调节人工周期组年龄33(30,36)岁。两组患者的基线资料,如年龄、不孕类型、不孕年限、体质指数(BMI)、抗米勒管激素(AMH)及基础内分泌水平差异均无统计学意义(均P>0。05)。对于RIF合并CE患者,降调节人工周期组患者既往移植失败次数多于人工周期组[M(Q1,Q3),3(3,4)次比4(3,4)次],临床妊娠率高于人工周期组[42。37%(25/59)比24。05%(19/79)](均P<0。05);使用GnRH-a预处理后的降调节人工周期法是RIF合并CE患者获得临床妊娠的影响因素(OR=2。229,95%CI:1。015~4。896,P<0。05)。结论 GnRH-a对于改善RIF合并CE患者的临床妊娠率具有一定疗效。
Impact of gonadotropin-releasing hormone agonist on pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with recurrent implantation failure combined with chronic endometritis
Objective To explore the impact of gonadotropin-releasing hormone agonist(GnRH-a)on the pregnancy outcomes in frozen-thawed embryo transfer cycles for patients with recurrent implantation failure(RIF)complicated by chronic endometriti(CE).Methods A total of 138 patients with RIF combined with CE who underwent in vitro fertilization/intracytoplamic sperm injection treatment-embryo transfer in the Department of Reproductive Medicine,Beijing Obstetrics and Gynecology Hospital,Capital Medical University from January 2020 to December 2023 were retrospectively included.According to the endometrial preparation protocol,they were divided into two groups:the pituitary downregulation group(n=59)and the artificial cycle group(n=79).The baseline data and pregnancy outcomes of the two groups were compared.Multivariate binary logistic regression analysis was conducted to assess the influencing factors of clinical pregnancy in patients with RIF complicated by CE.Results The age of the artificial cycle group[M(Q1,Q3)]was 33(31,37)years;the age of pituitary downregulation was 33(30,36)years.No statistically significant differences were found in the baseline data of the patients,such as age,the type of infertility,duration of infertility,body mass index(BMI),anti-Müllerian hormone(AMH),and baseline endocrine parameters(all P>0.05).For patients with RIF combined with CE,compared to the artificial cycle group,the pituitary downregulation group had a higher number of previous failed attempts[M(Q1,Q3),3(3,4)vs 4(3,4)],and a higher clinical pregnancy rate[42.37%(25/59)vs 24.05%(19/79)](P<0.05).GnRH-a pretreatment in a pituitary downregulation cycle is a factor influencing clinical pregnancy in patients with RIF combined with CE(OR=2.229,95%CI:1.015-4.896,P<0.05).Conclusion GnRH-a is effective in improving the clinical pregnancy rate of patients with RIF combined with CE.

EndometritisRecurrent implantation failureGonadotropin-releasing hormone agonistFrozen-thawed embryo transferRetrospective cohort study

王聪、方颖、沈帆、杨晓葵

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首都医科大学附属北京妇产医院/北京妇幼保健院生殖医学科,北京 100026

子宫内膜炎 反复种植失败 促性腺激素释放激素激动剂 冻融胚胎移植 回顾性队列研究

2025

中华医学杂志
中华医学会

中华医学杂志

北大核心
影响因子:1.477
ISSN:0376-2491
年,卷(期):2025.105(1)