降调节激素替代周期雌激素启动时机对既往移植失败患者FET临床结局的影响

目的 探讨降调节激素替代周期中不同雌激素启动时机对既往移植失败患者冻融胚胎移植(FET)临床结局的影响.方法 回顾性分析2018年1月至2019年12月于本中心采用降调节激素替代周期准备内膜后行FET的既往移植失败患者的临床资料(共316个周期).根据促性腺激素释放激素激动剂(GnRH-a)降调节后雌激素启动时机分为两...

Effect of estrogen initiation time on pregnancy outcome of FET cycles with hormone replacement after down-regulation in patients with previous transplantation failure

Objective:To investigate the effect of estrogen initiation timing on clinical outcome of frozen-thawed embryo transfer(FET)cycles with hormone replacement after down-regulation in patients with previous transplantation failure.Methods:The clinical data of 316 cycles with previously failed transplantation which underwent endometrial preparation by using GnRH-a down-regulated hormone replacement cycles were analyzed.According to the timing of estrogen initiation after GnRH-a down-regulation,the cycles were divided into two groups:the exogenous estrogen was added at 14-29 days after down-regulation in group A(157 cycles)and the exogenous estrogen was added at 30-40 days after down-regulation in group B(159 cycles).The general situation,clinical indicators after down-regulation and clinical outcomes were compared between the two groups.Results:There were no significantly differences in age,body mass index(BMI),infertility years,basic sex hormones(FSH,LH,E₂)between the two groups(P>0.05).The amount of exogenous estrogen used in group B was significantly less than that in group A[(85.27±33.77)mg vs.(95.20±39.59)mg,P<0.05].The embryo implantation rate(33.44%vs.25.96%),clinical pregnancy rate(51.57%vs.40.13%)and live birth rate(44.65%vs.33.76%)of group B were significantly higher than those of group A(P<0.05).Conclusions:The estrogen therapy initiated 30-40 days after the GnRH-a down-regulation can decrease the amount of exogenous estrogen used,increase the embryo implantation rate,clinical pregnancy rate and live birth rate,and improve the clinical outcomes in FET cycles of patients with previous transplantation failure.