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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。
Objective: To investigate the effect of mechanical stimulation of endometrium on clinical outcome and its mechanism. Methods: Sixty-three infertile patients with endometrial dysplasia who underwent extracorporeal fertilization-embryo transfer (IVF-ET) and whose natural menstrual cycle follicles were advanced were randomly divided into study group (n = 30) and control group = 33). The study group underwent mechanical stimulation of the endometrium 1 to 2 weeks prior to embryo transfer and the control group received no mechanical stimulation to statistically analyze the clinical outcome of IVF-ET. Results: There was no significant difference in the amount of Gn, the value of P / E2 on hCG injection day, the average number of oocytes retrieved, the fertilization rate and the number of transplanted high quality embryos (P> 0.05). The endometrial morphology and endometrial and endometrial (P <0.01). The embryo implantation rate and clinical pregnancy rate in the study group were significantly higher than those in the control group (P <0.01), and the rate of early miscarriage was significantly decreased (P <0.01). Conclusion: Mechanical stimulation of endometrium may improve embryo implantation rate and clinical pregnancy rate and reduce early miscarriage rate by improving endometrial morphology and endometrial and subintimal blood flow.