垂体降调节对卵巢功能减退年轻患者冻融胚胎移植结局的影响

目的探讨垂体降调节人工周期对卵巢功能减退(DOR)年轻患者(年龄≤40岁)冻融胚胎移植结局的影响。方法回顾性分析2016年3月至2018年12月在本院生殖中心就诊的296例年轻DOR患者的临床资料,按照内膜准备方法分为两组:降调节人工周期组(n=123)和人工周期组(n=173),比较两组患者的一般资料及妊娠结局,统计分析两组患者各项指标的差异。结果两组患者的年龄、不孕年限、体重指数、基础FSH、LH、E2、T、P和PRL水平、胚胎距宫底距离、移植日E2水平、移植日内膜厚度、优胚率均无显著性差异(P>0.05);与人工周期组相比较,降调节人工周期组的着床率(37.9%vs.28.0%)及临床妊娠率(55.28%vs.38.73%)显著升高(P<0.05),而早期流产率(8.82%vs.25.37%)和移植日孕酮水平(50.61±16.84)nmol/L vs.(57.40±18.24)nmol/L]显著降低(P<0.05)。结论对卵巢功能减退年轻患者行冻融胚胎移植,降调节人工周期可改善其妊娠结局。

Influence of GnRH agonist down-regulation on clinical outcomes of frozen-thawed embryo transfer cycle in younger patients with diminished ovarian reserve

Objective:To investigate the effect of GnRH agonist(GnRH-a)down-regulation combined with hormone replacement treatment(HRT)on the clinical outcomes of frozen-thawed embryo transfer(FET)cycles in younger patients with diminished ovarian reserve(DOR).Methods:The data of 296 DOR patients younger than 40 years old were retrospectively analyzed in the Reproductive Medical Center of Yuhuangding Hospital from March 2016 to December 2018.According to the different methods of endometrial preparation,the patients were divided into two groups:GnRH-a down-regulation combined with HRT in group A(n=123)and only HRT(artificial cycle)in group B(n=173).The general information and pregnancy outcomes of the two groups of patients were compared,and the differences in various indicators of the two groups of patients were statistically analyzed.Results:There was no significant difference in patients’age,duration of infertility,BMI,basal levels of FSH,LH,E 2,progesterone,testosterone and PRL,the distance of the embryo to the uterine fundus,the levels of E 2 on the day of embryo transfer,thickness of endometrium on the day of embryo transfer and high quality embryo rate(P>0.05).However,the embryo implantation rate(37.90%vs.28.00%)and clinical pregnancy rate(55.28%vs.38.73%)in group A were significantly higher than those in group B(P<0.05).The early abortion rate(8.82%vs.25.37%)and progesterone levels on the day of embryo transfer(50.61±16.84)vs.(57.40±18.24)nmol/L]in group A were significantly lower than those in group B(P<0.05).Conclusions:GnRH agonist combined with HRT can improve the pregnancy rate of frozen-thawed embryo transfer for the younger patients with diminished ovarian reserve.