垂体降调节对不明原因反复种植失败患者冻融胚胎移植周期的影响

目的:探讨垂体降调节后激素替代方案对不明原因反复种植失败(RIF)患者冻融胚胎移植周期的影响。方法:回顾性分析2012年1月至2015年12月在中山大学附属第六医院生殖中心使用垂体降调方案进行冻融胚胎移植的不明原因RIF患者118例的291个冻融周期。其中GnRH-a垂体降调节周期131个周期(A组,118例),非降调周期160个周期(B组,95例)。比较两组基本情况、周期特点及周期妊娠结局的差异。结果:A组患者的既往冷冻周期数高于B组(2.40±0.10个vs1.76±0.07个),差异有统计学意义(P0.01),而两组的年龄、不孕类型、不孕年限、BMI、基础FSH、窦卵泡数及移植胚胎数、优质胚胎率、转化日或排卵日内膜厚度比较,差异均无统计学意义(P0.05);A组患者的种植率、生化妊娠率、临床妊娠率及持续妊娠率均高于B组,差异有统计学意义(P0.01),A组患者流产率低于B组,差异有统计学意义(P0.01)。结论:对不明原因RIF不孕患者,在冻融胚胎移植周期使用垂体降调节方案有望改善此类患者的助孕治疗结局。

The Effect of Long-Term Pituitary Down-Regulation before Frozen Embryo Transfer for Patients Suffering From Idiopathic Repeated Implantation Failure

Objective:To explore the effect of long-term pituitary down-regulation before frozen-embryo transfer(FET) for idiopathic RIF patients.Methods:291 FET cycles of 118 idiopathic RIF patients who had undergone down-regulation protocol before FET was analyzed.There were 131 down-regulation cycles (Group A,118 cases)and 160 control cycles (Group B,95 cases).Demographic data,cycle characteristics and clinical outcome were compared.Results:Although patients in Group A had more previous attempts than Group B(2.40 ±0.10 vs 1.76 ±0.07,P ＜0.01),they have no significant differences in age,infertility duration,BMI,basal FSH,AFC,numbers of embryo transferred,embryo grade,and endometrium thickness(P ＞ 0.05).Compared with Group B,Group A achieved significantly higher biochemical pregnancy rate,clinical pregnancy rate,implantation rate,ongoing pregnancy rate (P ＜ 0.01) and significantly lower miscarriage rate (P ＜ 0.01).Conclusions:Long-term pituitary down-regulation protocol may help promoting clinical outcome of idiopathic RIF patients undergo FET.