经皮穴位电刺激改善冻融胚胎移植周期患者子宫内膜容受性的临床研究

目的观察经皮穴位电刺激对行IVF冻融胚胎移植周期患者的子宫内膜容受性的影响。方法将90例IVF-ET周期中因不明原因子宫内膜生长不良而受孕失败的患者随机分为两组,观察组从月经第5 d起使用经皮穴位电刺激进行干预,至下次月经来潮为1疗程,2个疗程后,第三个月经周期自月经第五天开始每日一次经皮穴位电刺激治疗,直至排卵日,排卵后给与黄体酮100 mg/d黄体支持,排卵后三天行胚胎移植术;对照组于复苏周期当月月经第5天起每日口服戊酸雌二醇2 mg,口服12 d后加用黄体酮100 mg/d进行黄体支持,两组移植术后都加用HCG2000U,im,qod,连用3支。比较两组患者治疗前一般情况,复苏周期移植前子宫内膜厚度及内膜类型、子宫粘膜下血流参数、生化妊娠率及临床妊娠率。结果观察组移植前厚度及内膜类型较对照组改善明显（P〈0.05）。子宫内膜下血流参数中,观察组阻力指数（RI）及波动指数（PI）明显低于对照组,差异有统计学意义（P〈0.05）。临床妊娠率方面,观察组高于对照组,差异有统计学意义（P〈0.05）。结论经皮穴位电刺激能促进子宫内膜生长,改善子宫内膜容受性,促进胚胎着床,提高临床妊娠率。

Clinical Studies of Endometrial Receptivity in Patients with Cryopreserved Embryo Transfer Cycles Treating with Transcutaneous Electrical Point Stimulation

Objective Study the effect of transcutaneous electrical point stimulation(TEPS) in improving the endometrial receptivity in patients with cryopreserved embryo transfer cycles.Methods 90 cases of patients with infertility caused by poor endometrial development for unknown reasons were randomly divided into two groups.The treatment group was intervened by TEPS from the fifth day of menstruation to the next menstruation and which made a therapeutic course.Two courses later,the patients in treatment group were treated by TEPS from the fifth day of menstruation once daily until oviposit day.After ovulation,patients were given progestin with a dose of 100mg per day.Three days after ovulation,embryo transfer was carried out.The control group was given progynova from the fifth day of menstruation with the dose of 2mg per day.After taking 12 days continuously,patients were given progestin with a dose of 100mg per day as well.Both groups received HCG2000U for three times,im,qod after embryo transfer.Then we compared the general conditions,endometrial thickness and types,parameters of Submucosal uterine blood flow,biochemical pregnancy rates and clinical pregnancy rates.Results The endometrial thickness and types in treatment group were improved significantly(P<0.05).In the parameters of Submucosal uterine blood flow,RI and PI in treatment group were lower than that of control group,and there was a significant difference(P<0.05).And the clinical pregnancy rate of treatment group was higher than that of control group.Conclusion TEPS can promote the growth of endometrium,improve the endometrial receptivity,promote the embryo implantation and improve the clinical pregnancy rate.