外周血单个核细胞宫腔内灌注治疗对反复种植失败患者妊娠结局的影响

目的探讨自体外周血单个核细胞（PBMCs）宫腔内灌注治疗对反复种植失败（RIF）患者胚胎种植率和临床妊娠率的影响。方法按随机数字表法将纳入的39例拟行冷冻胚胎移植的RIF患者随机分为治疗组（20例）和对照组（19例），治疗组在移植前3d抽取外周血20ml，应用淋巴细胞分离液分离PBMC后行宫腔灌注。对照组移植前未行自体PBMC宫腔灌注。结果两组患者年龄、血清卵泡刺激激素（FsH）、取卵周期数、移植周期数、移植胚胎数和单周期移植优质胚胎数均无统计学差异（P〉0．05）。两组胚胎种植率（22．8％VS．6．4％）和临床妊娠率（50．0％VS．17．6％）比较，治疗组均显著高于对照组（P％0．05）。两组单周期活婴出生率（45．0％VS．17．6％）比较无统计学差异（P〉0．05）。结论自体PBMC宫腔内灌注治疗可以提高RIF患者胚胎种植率和临床妊娠率，故可作为RIF患者胚胎移植前提供可选择的处理方案。

Effect of intrauterine administration of peripheral blood mononuclear cells on the pregnancy outcome of patients with recurrent implantation failure

Objective： To investigate the effect of intrauterine administration of autologous peripheral blood mononuclear cells（PBMC）on implantation rate and pregnancy rate in patients with recurrent implantation failure（RIF）. Methods： Thirty nine RIF patients who received frozen/thawed embryo transfer were enrolled in this study. The patients were randomly divided into two groups： PBMC-treated group（n= 20）and non-treated group（n= 19）. Blood samples（20 ml）were obtained from individual patients three days before the frozen/ thawed embryo transfer. PBMCs were isolated by the standard Ficoll-Hypaque method. Then PBMCs were gently instilled in the uterine cavity by an intrauterine insemination catheter. The non-treated group did not receive intrauterine administration of autologous PBMCs. Results： The results showed that there were no significant differences in average of age, basal FSH levels, number of previous in-vitro fertilization embryo transfer, number of embryos transferred and number of good quality embryos between the two groups（P）0.05）. The implantation rate and clinical pregnancyrate of the PBMC-treated group were 22.8 %（13/57） and 50.0 % （ 10/20）, while those in the non-treated group were 6.4 % （3/47）and 17.6 % （3/17）respectively. The implantation rate and clinical pregnancy rate in the PBMC-treated group were significantly higher than those in the non-treated group （P〈0.05）. There were no significant differences in the live birth rates between the two groups（84.6% vs. 100%）. Conclusions. Intrauterine administration of autologous PBMC may be an effective approach to improve the embryo implantation rate and clinical pregnancy rate in patients with RIF.