慢性子宫内膜炎治疗后联合序贯移植对反复种植失败患者冻融胚胎移植临床妊娠结局的影响

目的 探究慢性子宫内膜炎（chronic endometritis,CE）治疗后联合序贯移植对反复种植失败（repeated implantation failure,RIF）患者冻融胚胎移植（frozen-thawed embryo transfer,FET）临床妊娠结局的影响。方法 选取2019年1月至2022年1月杭州市妇产科医院生殖医学中心收治的RIF行宫腔镜检查及子宫内膜病理检查的304例患者进行回顾性研究。根据合并CE情况及移植方法的不同，分为非CE/RIF卵裂期胚胎移植组（A组，n=120）、CE/RIF卵裂期胚胎移植组（B组，n=121）和CE/RIF序贯移植组（C组，n=63）,CE/RIF患者经抗生素治疗两周后再行宫腔镜检查及子宫内膜病理检测，比较各组冻融胚胎移植的临床妊娠率。结果 3组患者的平均移植胚胎数及转化日内膜厚度比较，差异均无统计学意义（P>0.05）。A组和B组的移植优胚率均显著高于C组（P<0.05）。B组和C组的胚胎着床率、临床妊娠率均显著高于A组（P<0.05），且C组的胚胎着床率、临床妊娠率均显著高于B组（P<0.05）。...

Effect of combined sequential embryo transfer after treatment of chronic endometritis on clinical pregnancy outcome of frozen-thawed embryo transfer in patients with repeated implantation failure

Objective To investigate the effect of sequential embryo transfer after chronic endometritis (CE) treatment on clinical pregnancy outcome of frozen-thawed embryo transfer (FET) in patients with repeated implantation failure (RIF). Methods A total of 304 patients admitted to Hangzhou Obstetrics and Gynecology Hospital for RIF for hysteroscopy and endometrial pathology from January 2019 to January 2022 were selected for a retrospective study. The patients were divided into non-CE/RIF cleavage embryo transfer group (group A, n=120), CE/RIF cleavage embryo transfer group (group B, n=121) and CE/RIF sequential embryo transfer group (group C, n=63) according to the combined CE status and transfer method. Patients with CE/RIF were treated with antibiotics for a fortnight followed by hysteroscopy and endometrial pathology, and the clinical pregnancy rate of frozen embryo transfer were compared. Results The mean number of embryos transferred and the thickness of the endometrium on the day of transformation were not statistically significant in the three groups (P>0.05). The rate of transfer of superior embryos was significantly higher in both groups A and B than those in group C (P<0.05). The rates of embryo transfer and clinical pregnancy were significantly higher in both groups B and C than those in group A (P<0.05), and the rates of embryo transfer and clinical pregnancy were significantly higher in group C than those in group B (P<0.05). There was no statistically significant difference in the early miscarriage rate, multiple pregnancy rate, ectopic pregnancy rate and live birth rate among the three groups (P>0.05). Conclusion Routine screening and aggressive treatment of CE followed by sequential transfer method in patients with RIF can significantly improve the implantation rate and clinical pregnancy rate, and it can be used as an effective embryo transfer strategy for patients with RIF.