|本期目录/Table of Contents|

[1]时娴,马彩辉,郑娟.不同内膜准备方案在35岁以下患者首次冻融单囊胚移植周期中的结局分析[J].医学研究与战创伤救治(原医学研究生学报),2022,24(5):460-464.[doi:10.3969/j.issn.1672-271X.2022.05.003]
　SHI Xian,MA Cai-hui,ZHENG Juan.Analysis of clinical outcomes of three endometrial preparation protocols in patients younger than 35 years receiving their first freeze-thawed single blastocyst transfer cycles[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2022,24(5):460-464.[doi:10.3969/j.issn.1672-271X.2022.05.003]
点击复制

不同内膜准备方案在35岁以下患者首次冻融单囊胚移植周期中的结局分析()
分享到62.8K

《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第24卷
期数:
2022年5期
页码:
460-464
栏目:
临床研究
出版日期:
2022-11-02

文章信息/Info

Title:
Analysis of clinical outcomes of three endometrial preparation protocols in patients younger than 35 years receiving their first freeze-thawed single blastocyst transfer cycles
作者:
时娴; 马彩辉; 郑娟
作者单位：361000厦门，陆军第七十三集团军医院生殖医学中心（时娴、马彩辉、郑娟）
Author(s):
SHI Xian;  MA Cai-hui;  ZHENG Juan
(Reproductive Medicine Center, Army 73rd Group Military Hospital of PLA, Xiamen 361000, Fujian,China)
关键词:
内膜准备; 冻融单囊胚移植; 35岁以下; 活产率
Keywords:
endometrial preparation;  freeze-thaw single blastocyst transfer;  patients younger than 35 years; live birth rate
分类号:
R714.8
DOI:
10.3969/j.issn.1672-271X.2022.05.003
文献标志码:
A
摘要:
目的分析不同子宫内膜准备方案在35岁以下患者首次行冻融单囊胚移植的临床结局。方法回顾性分析2017年1月-2020年10月在陆军第七十三集团军医院首次行冻融单囊胚移植年龄35岁以下患者的临床资料，共1580周期，按照不同内膜准备方案分为3组：单纯激素替代(HRT)组 (531周期)，促性腺激素释放激素激动剂(GnRHa)降调节后激素替代(GnRHa-HRT)组 (189周期)，自然周期(NC)组 (860周期)。分别比较3组患者的一般情况和临床结局，通过多因素logistic回归模型分析三种内膜准备方案对患者临床妊娠率和活产率的影响。结果HRT组年龄及转化日内膜厚度均显著低于GnRHa-HRT组和NC组(P＜0.05)，且HRT组临床妊娠率和活产率均较GnRHa-HRT组和NC组显著下降(P＜0.05)。二元logistic回归分析显示：校正混杂因素后，GnRHa-HRT组和NC组内膜准备方案较HRT组可显著提高临床妊娠率和活产率(P＜0.05)。结论GnRHa-HRT和NC内膜准备方案均可提高35岁以下患者冻融单囊胚移植的活产率，在临床工作中需结合患者具体情况制定个体化内膜准备方案。
Abstract:
ObjectiveTo compare the clinical outcomes of three endometrial preparation protocols in patients younger than 35 years receiving their first frozen-thawed single blastocyst transfer.MethodsWe retrospectively analyzed the patients younger than 35 years receiving their first frozen-thawed single blastocyst transfer at the Reproductive Medicine Center of the Army 73rd Group Military Hospital of PLA between January 2017 and October 2020. A total of 1580 cycles were included. All cycles were categorized into three groups according to their protocol of endometrial preparation: hormone replacement therapy (HRT) group (531 cycles), gonadotropin releasing hormone agonists (GnRHa) combined with HRT (GnRHa-HRT) group (189 cycles), and natural cycle (NC) group (860 cycles). The patient characteristics and clinical outcomes among groups were compared. Multivariate analyses were used to evaluate the association between endometrial preparation protocols and clinical pregnancy and live birth.ResultsFemale age, endometrial thickness in the HRT group were all significantly lower than those in the GnRHa-HRT group and the NC group (P＜0.05). The clinical pregnancy rate and live birth rate in the HRT group were all significantly lower than those in the GnRHa-HRT group and the NC group (P＜0.05). After the adjustion of confounding factors, the logistic regression analyses suggested that the clinical pregnancy rates and live birth rates in the GnRHa-HRT group and the NC group were significantly higher than those in the HRT group (P<0.05).ConclusionBoth GnRHa-HRT and NC protocols are associated with higher live birth rates in frozen-thawed blastocyst transfer cycles in young patients. Individualized endometrial preparation protocols should be formulated based on the characteristics of the patients in clinical circumstances.

参考文献/References:

[1]Roque M, Haahr T, Geber S, et al. Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes[J]. Hum Reprod Update, 2019, 25(1): 2-14.
[2]Glujovsky D, Farquhar C. Cleavage-stage or blastocyst transfer: what are the benefits and harms?[J] Fertil Steril, 2016, 106(2): 244-250.
[3]Gardner DK, Lane M, Stevens J, et al. Blastocyst score affects implantation and pregnancy outcome: towards a single blastocyst transfer[J]. Fertil Steril, 2000, 73(6): 1155-1158.
[4]Mackens S, Santos-Ribeiro S, Vijver A, et al. Frozen embryo transfer: a review on the optimal endometrial preparation and timing[J]. Hum Reprod, 2017, 32(11): 2234-2242.
[5]Li JC, Wang YH, Peng LY, et al. A Novel Promising Endometrial Preparation Protocol for Frozen-Thawed Embryo Transfer: A Randomized Controlled Trial[J]. Front Endocrinol (Lausanne), 2021, 12: 730059.
[6]Wu H, Zhou P, Lin X, et al. Endometrial preparation for frozen-thawed embryo transfer cycles: a systematic review and network meta-analysis[J]. J Assist Reprod Genet, 2021, 38(8): 1913-1926.
[7]Zheng Q, Zhang H, Xu S, et al. Optimal Endometrial Preparation Protocols for Frozen-thawed Embryo Transfer Cycles by Maternal Age[J]. Reprod Sci, 2021, 28(10): 2847-2854.
[8]Qi Q, Luo J, Wang Y, et al. Effects of artificial cycles with and without gonadotropin-releasing hormone agonist pretreatment on frozen embryo transfer outcomes[J]. J Int Med Res, 2020, 48(6): 300060520918474.
[9]An J, Li L, Zhang X, et al. A clinical and basic study of optimal endometrial preparation protocols for patients with infertility undergoing frozen-thawed embryo transfer[J]. Exp Ther Med, 2020, 20(3): 2191-2199.
[10]Li M, Xu L, Zhao H, et al. Effects of artificial cycles with and without gonadotropin-releasing hormone agonist pretreatment on frozen embryo transfer outcomes in patients with adenomyosis[J]. Sci Rep, 2021, 11(1): 19326.
[11]周雪源, 闻姬, 孔伟, 等. EMs患者长效GnRHa降调节后人工周期行FET的临床结局[J]. 国际生殖健康/计划生育杂志, 2019, 38(3): 194-196.
[12]陈海啸, 任建枝, 蔡嘉力, 等. 降调节联合激素替代内膜准备方案在冻融胚胎移植中非子宫内膜异位症人群的应用[J]. 中华生殖与避孕杂志, 2020, 40(11): 881-886.
[13]Li L, Liu L, Kou Z, et al. GnRH agonist treatment regulates IL-6 and IL-11 expression in endometrial stromal cells for patients with HRT regiment in frozen embryo transfer cycles[J]. Reprod Biol, 2022, 22(2): 100608.
[14]Robin C, Uk A, Decanter C, et al. Impact of endometriosis on oocyte morphology in IVF-ICSI: retrospective study of a cohort of more than 6000 mature oocytes[J]. Reprod Biol Endocrinol, 2021, 19(1): 160.
[15]Guo H, Wang Y, Chen Q, et al. Effect of Natural Cycle Endometrial Preparation for Frozen-Thawed Embryo Transfer in Patients with Advanced Endometriosis[J]. Med Sci Monit, 2016, 22: 4596-4603.
[16]孙小花, 郑娟, 任建枝. 降调节对子宫内膜异位症患者冻融胚胎移植结局的影响[J]. 中国当代医药, 2019, 26(24): 14-17.

相似文献/References:

备注/Memo

备注/Memo:
基金项目：厦门市医学优势亚专科建设项目（厦卫科教2018296）
更新日期/Last Update: 2022-11-16