人绒毛膜促性腺激素宫腔灌注改善反复着床失败患者冻融胚胎的助孕结局

目的：研究胚胎移植前人绒毛膜促性腺激素(human chorionic gonadotropin，hCG)宫腔灌注是否改善反复着床失败患者冻融胚胎移植的助孕结局。方法：采用前瞻性随机对照研究，纳入拟行复苏胚胎移植且符合反复着床失败(repeated implantation failure，RIF)诊断、并排除其他因素(如子宫畸形、宫腔分粘术后、输卵管积液、内分泌疾病、子宫内膜异位症)的患者140例，并将其通过计算机随机数字表随机分成hCG灌注组和对照组，两组患者的年龄、基础日雌激素水平、移植胚胎数、优胚数、移植前子宫内膜厚度差异均无统计学意义(均P>0.05)。hCG灌注组和对照组分别于胚胎移植日配制灌注液(分别为hCG+G2培养基液和G2培养基)，分别于胚胎移植3 min前注入宫腔40 μL灌注液。比较两组临床妊娠率、种植率是否存在差异。结果：hCG 灌注组的种植率和临床妊娠率均高于对照组(均P<0.05)。结论：胚胎移植前宫腔灌注hCG可改善RIF患者冻融胚胎移植的着床率和临床妊娠率。

Intrauterine injection of human chorionic gonadotropin improves pregnancy outcome in patients with repeated implantation failure in frozen-thawed embryo transfer

Objective: To investigate whether intrauterine injection of human chorionic gonadotropin (hCG)before the embryo transfer in a frozen-thawed transfer cycle can improve the pregnancy outcome inthe patients with repeated implantation failure (RIF).Methods: Prospective randomized-controlled trial was adopted. A total of 140 patients, whounderwent thawed embryo transplantation and were in line with the diagnosis of RIF, wereincluded. Other patients with some factors, such as uterine malformation, postoperative uterinecavity sticking, tubal effusion, endocrine diseases and endometriosis, were excluded. The patientswere randomly divided into 2 groups through the computer random number table: an hCGintrauterine perfusion group and a control group. There was no significant difference in the age,the estradiol level, the number of transplanted embryos, the number of optimal embryos, andthe thickness of the endometrium before transplantation between the 2 group (all P>0.05). ThehCG+G2 fluid and the G2 fluid were prepared on the day of embryo transfer, and 40 μL of whichwas injected at an intrauterine site at 3 minutes before embryo transfer in the hCG intrauterineperfusion group and the control group, respectively. The clinical pregnancy rate and implantationrate in the 2 groups were compared.Results: The implantation rate and the clinical pregnancy rate in the hCG intrauterine perfusiongroup were higher than those in the control group (both P<0.05).Conclusion: The intrauterine injection of hCG can improve the implantation rate and pregnancyrate in cryopreserved embryo transfer in patients with RIF.