评价改善子宫内膜容受性在体外受精胚胎移植术中作用的回顾性研究

目的：通过子宫内膜厚度及黄体期补充雌激素来评价和改善子宫内膜容受性。方法回顾性分析2009年1月-2012年5月行体外受精胚胎移植术（IVF-ET）的共3525个周期，经阴道超声检测子宫内膜厚度，黄体期单用黄体酮与黄体酮＋雌激素两种黄体支持效果的对比分析。结果子宫内膜厚度≤0.80 cm的患者妊娠率均显著低于≥0.80 cm者（P〈0.05），子宫内膜厚度≥1.40 cm妊娠率（63.93%）与子宫内膜厚度≥0.80-〈1.40 cm的妊娠率（53.86%）相比差异有统计学意义（P〈0.05）；单用黄体酮组总妊娠率为50.75%，黄体酮＋戊酸雌二醇组总妊娠率为54.90%，两组间差异无统计学意义（P≥0.05）。将黄体期单用黄体酮的周期内膜厚度≤0.80 cm为A组，≥0.80 cm为B组，将使用黄体酮＋戊酸雌二醇的周期内膜厚度≤0.80 cm为C组，≥0.80 cm为D组。A组与C组、B组与D组间妊娠率比较差异无统计学意义（P≥0.05）。 A、B组分别与D组流产率比较差异均有高度统计学意义（P〈0.01）。结论妊娠率随着子宫内膜厚度增加而增加，黄体期补充雌激素可以改善薄型子宫内膜患者子宫内膜容受性，降低流产率。

Retrospective study of evaluation on improving the endometrial receptivi-ty in vitro fertilization and embryo transplantation

Objective To evaluate and improve the endometrial receptivity by the endometrial thickness and estrogen supplementation in the luteal phase. Methods A retrospective analysis was carried out in 3525 cases of in vitro fertil-ization and embryo transplantation （IVF/ET） from January 2009 to May 2012. The endometrial thickness was deteeted with transvaginal ultrasound, and the effect between administration with progesterone alone and progesterone together with estrogen in the luteal phase was compared. Results The pregnancy rate in cases with endometrial thickness less than 0.80 cm （group A and C） was significantly lower than that in cases with endometrial thickness over 0.80 cm （group B and D） （P〈0.05）;the pregnancy rate in cases with endometrial thickness≥ 1.40 cm was 63.93%, which was sig-nificantly higher than that in cases with endometrial thickness of ＆gt;0.80-〈1.40 cm （53.86%） （P〈 0.05）; the total preg-nancy rate in progesterone alone group （group A and B） was 50.75%, the total pregnancy rate in progesterone together with estradiol group （group C and D） was 54.90%, and there was no significant difference between the two groups（P〉0.05）. Group A was progesterone alone and endometrial thickness≤0.80 cm in the luteal phase, group B was＆gt;0.80 cm;group C was progesterone together with estrogen in the luteal phase, group D was ＆gt; 0.80 cm. There was no significant difference in the pregnancy rate between group A and C, or between group B and D （P〉0.05）. In addition, the abor-tion rate in group D was significantly different with that of group A and B （P〈0.01）. Conclusion The pregnancy rate is positive correlated with endometrial thickness, and estrogen supplementation in the luteal phase in indi-viduals with thin endometrium can improve the en-dometrial receptivity and reduce the abortion rate.