冻融胚胎移植周期中粒细胞集落刺激因子宫腔灌注对薄型子宫内膜患者的疗效观察

目的观察薄型子宫内膜患者使用粒细胞集落刺激因子宫腔灌注后内膜形态、厚度的变化,分析在冻融胚胎移植周期中薄型子宫内膜患者使用粒细胞集落刺激因子宫腔灌注后胚胎种植率和临床妊娠率的变化。方法回顾性分析2016年12月-2018年12月在我院行冻融胚胎移植的186例薄型子宫内膜患者的临床资料,根据冻融胚胎移植前内膜准备时是否行粒细胞落刺激因子宫腔灌注治疗将患者分为研究组和对照组;内膜准备时在常规治疗基础上,加用粒细胞集落刺激因子宫腔灌注治疗的为研究组,共95例;内膜准备时只用常规治疗的为对照组,共91例。比较移植前子宫内膜准备时两组患者治疗前后子宫内膜形态和厚度的变化,对比胚胎移植后两组患者的胚胎种植率、临床妊娠率、流产率以及异位妊娠率。结果研究组治疗前后内膜形态比较、对照组治疗前后内膜形态比较、治疗后研究组与对照组内膜形态比较,差异无统计学意义(P>0.05);研究组治疗后内膜厚度较治疗前有增加、对照组治疗后内膜厚度较治疗前有增加、治疗后研究组内膜比对照组内膜厚,但差异无统计学意义(P>0.05);胚胎移植后研究组的胚胎种植率(24.85%)明显高于对照组(14.91%),差异有统计学意义(P<0.05),研究组临床妊娠率(41.05%)略高于对照组(30.77%),但差异无统计学意义(P>0.05)。结论未见粒细胞集落刺激因子宫腔灌注促使薄型子宫内膜患者内膜的形态和厚度发生有意义的变化;在冻融胚胎移植周期中薄型子宫内膜患者使用粒细胞集落刺激因子宫腔灌注后胚胎种植率高于常规治疗的患者,但临床妊娠率相差不大;提示粒细胞集落刺激因子宫腔灌注可以提高胚胎种植率,但作用机制可能并不是通过改变其子宫内膜形态或是增加其内膜厚度。

Therapeutic eff ect of uterine perfusion of granulocyte colony-stimulating factor on patients with thin endometrium during freeze-thaw embryo transfer

Objective:Changes in endometrial morphology and thickness after uterine perfusion with granulocyte colony-stimulating factor in patients with thin endometrium;Analysis of changes in embryo implantation rate and clinical pregnancy rate after intrauterine perfusion of granulocyte colony-stimulating factor in patients with thin endometrium during freeze-thaw embryo transfer.Methods:Retrospective analysis of clinical data of 186 patients with thin endometrium who underwent freeze-thawed embryo transfer in our hospital from December 2016 to December 2018,Patients were divided into study group and control group according to whether granulocyte-stimulating factor intrauterine perfusion was used during endometrial preparation before freeze-thaw embryo transfer.Comparison of endometrial morphology and thickness before and after treatment in two groups of patients before endometrial preparation;Comparison of embryo implantation rate,clinical pregnancy rate,abortion rate and ectopic pregnancy rate between the two groups after embryo transfer.Results:There was no significant difference in endometrial morphology and thickness between the two groups before and after treatment(P>0.05).The embryo implantation rate of the study group after embryo transfer(24.85%)was significantly higher than that of the control group(14.91%)(P<0.05).The clinical pregnancy rate of the study group(41.05%)was higher than that of the control group(30.77 %),but the difference was not statistically significant(P>0.05).Conclusion:Intrauterine perfusion of granulocyte colony-stimulating factor can not improve the intimal morphology of thin endometrial patients,and can not increase the thickness.Intrauterine perfusion of granulocyte colony-stimulating factor can increase embryo implantation rate,but can not improve clinical pregnancy rate.