生长激素联合低分子肝素在反复种植失败患者冻胚周期中的应用价值

doi:10.3969/j.issn.1671-7171.2020.11.003

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摘要【目的】探讨生长激素联合低分子肝素在反复种植失败患者冻胚周期中的应用价值。【方法】回顾性分析2017年10月至2018年12月在本院生殖中心诊治的辅助生殖助孕反复种植失败患者73例,按照治疗方法不同分为观察组和对照组。对照组采用常规激素替代方案,观察组在对照组基础上在冻胚周期应用生长激素和低分子肝素治疗。比较两组子宫内膜情况和妊娠结局。【结果】观察组黄体转化日内膜厚度、正常内膜形态率、移植日内膜厚度分别为(9.9±1.9)mm、86.5%、(10.3±1.9)mm,与对照组的(9.3±0.8)mm、80.9%、(9.4±0.7)mm比较均明显改善,其差异有统计学意义(P<0.05);观察组临床妊娠率、胚胎种植率、活产率分别为38.5%、 24.21%、26.9%,与对照组的 28.6%、16.31%、19.0%比较差异均无统计学意义(P>0.05)。【结论】在反复种植失败患者冻胚周期中应用生长激素结合低分子肝素后,可有效改善子宫内膜的厚度和形态,对子宫内膜容受性具有积极作用,但对胚胎种植率、临床妊娠率、活产率无明显提高。

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关键词 ：生长激素, 肝素, 低分子量, 胚胎移植, 生殖技术, 辅助, 冷冻, 治疗失败

Abstract：【Objective】To investigate the clinical efficacy of growth hormone combined with low-molecular-weight heparin in the frozen embryo cycle of patients with recurrent implantation failure. 【Methods】A retrospective analysis from Reproductive Center of Hunan Maternal and Child Health Hospital was studied on the clinical effect of 73 assisted-reproduction patients with recurrent implantation failures during 2017-2018. According to different treatment methods, patients were divided into the observation group (n=52) and the control group (n=21). Conventional hormone replacement program was used in the control group, while growth hormone combined with low molecular weight heparin was applied in the observation group. The endometrial condition and pregnancy outcome of the two groups were compared. 【Results】The comparison of the endometrial thickness of the corpus luteum transformation, percentage of normal endometrial morphology, and implant day endometrial thickness between the observation group and the control group were: 9.9±1.9 mm vs 9.3±0.8 mm、86.5% vs 80.9% and 10.3±1.9 mm vs 9.4±0.7 mm, respectively. The differences were statistically significant (P<0.05). The clinical pregnancy rate, embryo implantation rate, and live birth rate of the observation group were 38.5 %, 24.2%, and 26.9%, respectively, while those rates of the control group were 28.6%, 16.3% and 19.0%, respectively. There were no statistically significant differences (P>0.05). 【Conclusion】After the application of growth hormone combined with low molecular weight heparin in the frozen embryo cycle of patients with recurrent implantation failure, it can effectively improve the thickness and morphology of endometrium, which enhances endometrial receptivity. It provides a new idea for the strategy of assisted pregnancy for patients with recurrent implantation failure, though the embryo implantation rate, clinical pregnancy rate, and live birth rate of the study group were not really increased.

Key words： Growth Hormone Heparin, Low-Molecular-Weight Embryo Transfer Reproductive Techniques, Assisted Freezing Treatment Failure

收稿日期: 2020-06-09

PACS:

R321.33

基金资助:湖南省卫生计生委科研计划课题基金(编号:B20180754)

通讯作者: **E-mail:519286369@qq.com

引用本文:

文壹, 毛增辉, 周丽媛, 唐君, 康革华. 生长激素联合低分子肝素在反复种植失败患者冻胚周期中的应用价值[J]. 医学临床研究, 2020, 37(11): 1608-1611.
WEN Yi, MAO Zeng-hui, ZHOU Li-yuan, et al. Application of Growth Hormone Combined with Low-molecular Weight Heparin in Frozen Embryo Cycle of Patients with Recurrent Implantation Failure. JOURNAL OF CLINICAL RESEARCH, 2020, 37(11): 1608-1611.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2020.11.003 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2020/V37/I11/1608