阿托西班联合人绒毛膜促性腺激素宫腔灌注对不孕症患者妊娠结局的影响

目的 探讨阿托西班联合人绒毛膜促性腺激素(hCG)宫腔灌注对不孕症患者妊娠结局的影响.方法 选择2015年1月至2017年2月安徽医科大学附属妇幼保健院生殖中心胚胎着床失败2次或2次以上的患者121例,按随机数字表法分成A(39例)、B(40例)、C(42例)3组.其中,A组患者给予hCG宫腔灌注治疗,灌注后行冻融胚胎移植(F-ET)45个周期,B组患者静推阿托西班后,行F-ET44个周期,C组患者给予宫腔灌注联合阿托西班静推,后行F-ET45个周期.比较3组患者临床妊娠率、多胎妊娠率、着床率、流产率、异位妊娠率及活产率情况.结果 3组患者的胚胎着床率、活产率比较,差异有统计学意义(P<0.05).C组患者胚胎着床率(43.53％)高于A组(21.84％)和B组(31.76％),与A组比较,差异有统计学意义(χ2=9.212,P=0.002),与B组比较,差异无统计学意义(χ2=2.506,P=0.113);C组患者活产率(57.78％)高于A组(28.89％)和B组(45.45％),与A组相比,差异有统计学意义(χ2=7.647,P=0.006),与B组相比,差异无统计学意义(χ2=1.353,P=0.245).结论 F-ET前给予阿托西班静推联合hCG宫腔灌注可提高F-ET着床率和活产率.

Effects ofintravenous atosiban combined with intrauterine human chorionic gonadotropin injections on pregnancy outcomes in infertility women

Objective To explore the effects of intravenous atosiban combined with intrauterine human chorionic gonadotropin ( hCG) injections on pregnancy outcomes in those infertility women. Methods 121 infertility women underwent more than once failed em-bryo implantation in our reproductive center between Jan 2015 and Feb 2017 were collected, and then divided into three groups by means of random number table. Group A (39 cases) received 45 cycles of frozen-thawed embryo transfer ( FET) after intrauterine hCG injection, group B (40 cases) received 44 cycles of FET after intravenous atosiban injection, and group C (42 cases) received 45 cycles of FET after intrauterine atosiban combined with intrauterine hCG injections. The rates of clinical pregnancy, multiple pregnancy, implantation, abortion, ectopic pregnancy and live delivery were compared among the three groups. Results There were significant differences in the embryo im-plantation rate and live delivery rate among the patients of these groups (P<0. 05). The embryo implantation rate in group C (43. 53％) was higher than those in group A (21. 84％) and group B (31. 76％), and it was significantly different from that in group A (χ2 =9. 212, P=0. 002), but was not significantly different from that in group B (χ2 =2. 506, P=0. 113). The live delivery rate in group C (57. 78％) was higher than those in group A (28. 89％) and group B (45. 45％), and there was significant difference when compared with group A (χ2=7. 647, P=0. 006), but there was no significant difference in comparison with group B (χ2 =1. 353, P=0. 245). Conclusion Appli-cation of intravenous atosiban and intrauterine hCG injections before FET in those infertility women with failed FET could improve the embryo implantation rate and live delivery rate.