粒细胞集落刺激因子治疗冻融胚胎移植周期薄型子宫内膜的研究

目的探讨粒细胞集落刺激因子(G-CSF)在冻融胚胎移植周期(FET)中治疗薄型子宫内膜的疗效。方法选择2011年8月至2012年12月在中山大学孙逸仙纪念医院生殖中心行FET且子宫内膜厚度≤7mm的不孕症患者59例,34例在排卵日或黄体酮/HCG注射日行宫腔灌注G-CSF(100μg/0.6mL)。应用G-CSF治疗的40个周期作为G-CSF组,49个既往周期作为自身对照组,25例未应用G-CSF治疗者80个周期作为对照组。结果与自身对照组或对照组相比,G-CSF组内膜准备方案中诱发排卵周期比例高,自然周期比例低,有显著差异(P0.05);三组周期取消率依次为:自身对照组69.39%,对照组48.75%,G-CSF组17.50%,组间有显著差异(P0.05);三组胚胎种植率和临床妊娠率分别是:G-CSF组15.85%和30.30%,自身对照组7.89%和20.00%,对照组13.33%和29.27%,组间无统计学差异(P0.05)。结论 G-CSF治疗未能显著改善子宫内膜菲薄的不孕患者的胚胎种植率和临床妊娠率。

Administration of granulocyte colony-stimulating factor for .infertile women with thin endometrium in frozen embryo transfer program

Objectives： To evaluate the effectiveness of granulocyte colony-stimulating factor（G-CSF）on infertile women wiih thin endometrium in frozen embryo transfer（FET）program. Methods： Among 59 infertile patients with thin endometrium（~7mm）undergoing FET in the Reproductive Medicine Centre of Memorial Hospital of Sun Yat-Sen University from August 2011 to December 2012,34 patients with 40 cycles received uterine infusion of recombinant human G-CSF（100μg/0.6mL）on the day of ovulation or administration of progesterone or HCG as C,-CSF group, 49 previous cycles as self-controlled group, and 25 patients with 80 cycles and without applying recombinant human Cr-CSF were as control group. Results： Higher proportion of induced ovulation cycles and lower proportion of natural cycles in the endometrial preparation protocols were observed in G-CSF group, when compared with self-controlled group or control group（P〈0.05）. In descending order, the cycle cancellation rate was 69. 39% in self- controlled group,48.75% in control group,and 17.50% in G-CSF group,with significant difference （ P〈0.05）. The implantation rate and clinical pregnancy rate per embryo transfer were similar in all groups,with 15.85% and 30.30% in G-CSF group,7.89% and 20.00% in self-controlled group,and 13.33% and 29.27% in control group, respectively（P〉0.05）. Conclusions： It fails to demonstrate that G-CSF has the potential to improve embryo implantation and clinical pregnancy rate of the infertile women with thin endometrium.