激素替代周期内膜转化日血清雌二醇水平与冻融胚胎移植结局的关系

目的探讨激素替代周期(HRT)内膜转化日不同的血清雌二醇(E 2)水平对冻融胚胎移植(FET)妊娠结局的影响。方法选择2016年1月至2019年4月于佛山市妇幼保健院生殖中心进行激素替代周期冻融胚胎移植(HRT-FET)的患者1398例,共1502个周期,移植胚胎均为卵裂期胚胎。根据E 2水平的不同,将患者分为3组:A组:E 2≤550.5 pmol/L(533周期);B组:550.5 pmol/L1101 pmol/L(230周期)。对比三组间的妊娠结局;同时根据临床结局的不同将患者分为临床妊娠组(683周期)和非临床妊娠组(819周期),比较两组之间血清E 2的差异。结果C组临床妊娠率最低,显著低于B组、A组(34.3%vs.46.7%、48.6%,P<0.05),A组与B组间差异无统计学意义(P>0.05);三组之间的流产率、异位妊娠率均无统计学差异(P>0.05)。临床妊娠组内膜转化日血清E 2显著低于非临床妊娠组(756.1±580.2)pmol/L vs.(838.4±716.3)pmol/L](P<0.05)。结论当HRT-FET周期内膜转化日血清E 2水平>1101 pmol/L时,将降低卵裂期胚胎FET的临床妊娠率。

Relationship between serum estradiol level on endometrial transformation day and pregnancy outcome of frozen-thawed embryo transfer in hormone replacement cycle

Objective:To investigate the effect of different serum estradiol(E 2)levels on endometrial transformation day on the pregnancy outcome of frozen-thawed embryo transfer in hormone replacement therapy(HRT-FET)cycle.Methods:The data of 1398 patients(1502 cycles)undergone HRT-FET cycle in the reproductive center of Foshan Maternal&Children Hospital from January 2016 to April 2019 were retrospectively analyzed.All the embryos transferred were at the cleavage stage.According to the different E 2 levels,the patients were divided into three groups:group A(E 2≤550.5 pmol/L,533 cycles),group B(550.5 pmol/L1101 pmol/L,230 cycles).The pregnancy outcomes were compared among the three groups.The patients were subdivided into two groups according to different clinical outcomes:clinical pregnancy group(683 cycles)and non-clinical pregnancy group(819 cycles).The levels of serum E 2 were compared between the two groups.Results:The clinical pregnancy rate of group C was the lowest,which was significantly lower than that of group B and group A(34.3%vs.46.7%vs.48.6%,P<0.05).There was no significant difference between group A and group B(P>0.05).There was no significant difference in abortion rate and ectopic pregnancy rate among the three groups(P>0.05).The serum E 2 on the day of endometrial transformation in clinical pregnancy group(756.1±580.2)pmol/L]was significant lower than that in non-clinical pregnancy group(838.4±716.3)pmol/L](P<0.05).Conclusions:When serum E 2 level on the day of endometrial transformation are more than 1101 pmol/L,the clinical pregnancy rate of FET with embryo at the cleavage stage is decreased.