机械刺激子宫内膜对内膜形态不良者IVF-ET临床结局的影响

目的:探讨机械刺激子宫内膜对临床结局的影响及机制。方法:选取行体外受精-胚胎移植(IVF-ET)且其自然月经周期卵泡晚期超声提示子宫内膜形态不良的不育患者63例,随机分为研究组(n=30)和对照组(n=33)。研究组在胚胎移植前1～2周对子宫内膜行机械刺激,对照组未行机械刺激为,统计分析IVF-ET的临床结局。结果:Gn用量、hCG注射日P/E2值、平均获卵数、受精率及移植优质胚胎数组间无统计学差异(P>0.05);研究组子宫内膜形态及子宫内膜和内膜下血流均较对照组有明显改善(P<0.01);研究组的胚胎种植率及临床妊娠率明显高于对照组(P<0.01),早期流产率明显降低(P<0.01)。结论:机械刺激子宫内膜可能是通过改善子宫内膜形态及子宫内膜和内膜下血流,从而提高胚胎种植率及临床妊娠率,降低早期流产率。

Effect of Mechanical Stimulation on IVF-ET Clinical Outcome in Women with Abnormal Endometrium

Objective: To study the influence of mechanical stimulation on IVF-ET clinical outcome.Methods: In the cycle of in vitro fertilization-embryo transfer(IVF-ET),63 patients were studied who were with abnormal endometrial echoes by ultrasound in follicular phase in natural period.They were devided into two groups: 30 patients(experimental group) were mechanical stimulated to the endometrium during 1-2 weeks before embryo transfer.The remaining 33 patients(control group) were not treated.Results: There were no statistical differences between the two groups on the dose of Gn use,the impact of serum progesterone / estratiol ratio on hCG administration day,the number of oocytes retrieved,the rate of fertilization and the number of good embryos transferred(P>0.05).After mechanical stimulation to the endometrium,endometrial pattern,endometrial and subendometrial blood flows on the day of hCG administration were improved than those of the control(P<0.01).Embryo implantion rate,clinical pregnancy rate were significantly improved,while early spontaneous abortion rate was delated than that in the control(P<0.01).Conclusion: Mechanical stimulation to the endometrium significantly improves the rates of embryo implantation,clinical pregnancy in patients undergoing in vitro fertilization while decrease the rate of early spontaneous abortion perhaps through affecting endometrial and subendometrial blood flows.