重组人粒细胞集落刺激因子治疗IVF-ET不明原因反复种植失败患者的效果研究

目的探讨重组人粒细胞集落刺激因子(recombinant human granulocyte colony stimulating factor, rh G-CSF)治疗不明原因反复胚胎种植失败(unexplained repeated implantation failure, uRIF)患者的效果及安全性。方法选择2018年1月-2019年4月在我院行第四次冻融胚胎移植的uRIF患者120例,根据药物治疗方法的不同分为观察组和对照组各60例。观察组在解冻移植前1 h皮下注射rh G-CSF 300 U,移植后第3、5日再分别皮下注射rh G-CSF 150 U,同时予常规黄体支持治疗;对照组仅予常规黄体支持治疗。比较两组生化妊娠率、临床妊娠率、胚胎种植率、流产率以及应用安全性。结果观察组生化妊娠率、临床妊娠率及胚胎种植率均高于对照组,差异均有统计学意义(P<0.05或P<0.01),但两组流产率比较差异无统计学意义(P>0.05);观察组仅2例出现轻微发热(<38℃),第2日自行缓解,无其他不良反应。结论 rh G-CSF能够改善uRIF患者再次解冻移植的妊娠结局,且应用安全性较好。

Effect of Recombinant Human Granulocyte Colony Stimulating Factor in the Treatment of IVF-ET Patients with Unexplained Repeated Implantation Failure

Objective To explore the efficacy and safety of recombinant human granulocyte colony stimulating factor(rh G-CSF) in the treatment of patients with unexplained repeated embryo implantation failure(uRIF). Methods A total of 120 uRIF patients undergoing the fourth frozen-thawed embryo transfer(FET) from January 2018 to April 2019 in our hospital were randomly divided into observation group(n=60) and control group(n=60) according to different drug treatment methods. The observation group was given rh G-CSF 300 U 1 h before embryo transfer and subcutaneous injection of the rh G-CSF 150 U at 3 and 5 d after embryo transplantation respectively, and in the meantime, conventional luteal support therapy was given. The control group only received conventional luteal support. Biochemical pregnancy rate, clinical pregnancy rate, embryo implantation rate, abortion rate and application safety between the two groups were compared. Results The biochemical pregnancy rate, clinical pregnancy rate and embryo implantation rate were significantly higher in observation group than in control group(P<0.05 or P<0.01), but there was no significant decrease in abortion rate(P>0.05);In the observation group, only 2 cases had slight fever(<38℃), which was relieved on the second day without any other adverse reactions. Conclusion rh G-CSF can improve the pregnancy outcome of FET in uRIF patients, which has good safety.