两种子宫内膜准备方案对冷冻胚胎移植妊娠结局影响的临床随机对照研究

目的：比较月经规律患者冷冻胚胎移植周期两种子宫内膜准备方案对妊娠结局的影响。方法：采用单盲、前瞻性临床随机对照研究方法,选取2010年1月到2012年2月于中山大学孙逸仙纪念医院生殖中心行冷冻胚胎移植的月经规律、年龄≤40岁,可利用冷冻胚胎数≥3的139例患者。将患者随机分为自然周期组（NC组,70例）和激素替代周期组（HRT组,69例）,其中NC组中62例、HRT组中56例完成了冷冻胚胎移植。比较两组患者的内膜厚度、ET日的E2水平、周期取消率、着床率、妊娠率、临床妊娠率、继续妊娠率和早期自然流产率。结果：NC组和HRT组的周期取消率分别为11.43%和18.84%,着床率为16.97%和15.89%,妊娠率为38.70%和35.71%,临床妊娠率为35.48%和30.36%,继续妊娠率为29.03%和28.57%,早期自然流产率为13.64%和5.88%,两组比较均无显著差异（P〉0.05）。NC组的内膜厚度（10.16±2.30）mm]厚于HRT组（8.84±1.26）mm],胚胎移植日的E2水平（157.48±88.46）ng/L]低于HRT组（273.57±284.76）ng/L],均有显著差异（P〈0.05）。结论：NC与HRT准备子宫内膜对冷冻胚胎移植的妊娠结局无影响。

The effects of different endometrium preparation protocols on the pregnancy outcome of frozen-thawed embryo transfer：a prospective randomized clinical trial

Objective：To explore the effects of two endometrium preparation protocols in frozen-thawed embryos transfer for the patients with regular cycles. Methods：This was a pro-spective randomized controlled clinical trial. Patients with regular cycles undergoing FET in the reproductive center of Sun Yat-sen Memorial Hospital were recruited from Jan. 2010 to Feb. 2012 ,who should not be elder than 40 years old and had more than 3 frozen embryos. The pa- tients were divided into two groups： the natural cycle group （70 cases） and the hormone re- placement therapy （HRT） cycle group （69 cases）. 62 cases of the natural cycle group and 56 cases of the hormone replacement therapy cycle finished this Trial. The cancellation rates, endo- metrial thickness, levels of E2 at ET day, implantation rates, pregnancy rates, clinical pregnancy rates, ongoing pregnancy rates and first trimester abortion rates between the two groups were compared. Results： There was no significant difference of cancellation rates （ 11. 43% vs 18.84% ） ,implantation rates（ 16.97% vs 15.89% ）, clinical pregnancy rates （35. 48% vs 30. 36%） 28.57% ） and first trimester abortion rate （ 13.64% pregnancy rates（38.70% vs 35.71% ） , ongoing pregnancy rates （29. 03% vs vs 5.88% ）between the natural cycle group and the HRT group（P〉0.05 ）. But the endometrium in the natural cycle group （10.16± 2.30） mm] was thicker than the HRT group （ 8.84±1.26） mm] （P〈0.05）. The level of E2 at ET day in the hormone replacement therapy cycle group （273.57±284.76）ng/L] was signifi-cantly higher than that of the nature cycle group （157.48±88.46） ng/L] （P〈0.05）. Conclu-sion：Patients with regular cycle can achieve a good pregnancy outcome by two endometrium preparation protocols.