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目的探讨在冷冻胚胎-解冻移植(冻融胚胎移植,FET)周期中,子宫内膜微刺激术对自然周期患者子宫内膜评价指标及临床妊娠率的影响。方法 2013年1-7月于兰州大学第一医院生殖医学研究中心,前瞻性观察自然周期法实施冷冻胚胎-解冻移植术的不孕症患者591例,采用随机数字表法,将同期符合纳入标准行FET术的患者随机分为两组,分别为内膜刺激组与对照组,其中211例行内膜微刺激术(内膜刺激组),380例为对照组,对比不同时间和次数内膜微刺激对内膜形态特征的改善,分析微刺激术对FET周期治疗结局的影响。结果内膜微刺激术后超声监测HCG日两组子宫内膜厚度差异无统计学意义(P>0.05);与对照组相比,内膜刺激组临床妊娠率差异无统计学意义(P>0.05)。月经期和黄体期行内膜微刺激术两组临床妊娠率分别为60.00%和64.29%(P>0.05);治疗前周期和第二周期移植妊娠率差异均无统计学意义(56.67%vs.60.00%,P>0.05);第1次和第2次行内膜微刺激术后妊娠率为56.67%vs.54.17%(P>0.05)。结论自然周期阴道超声监测子宫内膜提示形态较差的患者经内膜微刺激后可显著改善子宫内膜条件。内膜形态为C型的患者经微刺激后转为A型,可获得与对照组相同的妊娠率。
Objective To investigate the effect of endometrial micro-stimulation on endometrial evaluation index and clinical pregnancy rate in patients with natural cycles during frozen-thawed embryo-thawed embryo transfer (FET) cycles. Methods From January to July 2013, 591 infertile patients who underwent frozen embryo-thawing were prospectively observed in the Reproductive Medicine Research Center of the First Hospital of Lanzhou University from January to July, 2013. The random number table was used to meet the inclusion criteria Patients underwent FET surgery were randomly divided into two groups, namely intimal stimulation group and control group, of which 211 cases of endometrial stimulation (endometrial stimulation group), 380 cases of control group, compared with different time and number of intima Micro-stimulation improves the morphologic features of the endometrium, and analyzes the effect of micro-stimulation on FET cycle outcomes. Results There was no significant difference in endometrial thickness between the two groups after HCT (P> 0.05). There was no significant difference in the clinical pregnancy rate between the endometrial stimulation group and the control group (P> 0.05 ). The clinical pregnancy rates of menstruation and luteal phase endomyocardial stimulation were 60.00% and 64.29% respectively (P> 0.05). There was no significant difference in pregnancy rate between the pre-treatment period and the second period (56.67% vs. 60.00%, P> 0.05). The pregnancy rates after the first and second endometrial micro-stimulation were 56.67% vs.54.17% (P> 0.05). Conclusion Natural period vaginal ultrasound monitoring of the endometrium prompted poor morphology in patients with endometrial micro-stimulation can significantly improve the endometrial conditions. Patients with endometrial morphology of type C were converted to type A by micro-stimulation and the same pregnancy rate was obtained as in the control group.