自然周期与降调节后人工周期在玻璃化 冻融囊胚移植周期中的应用

Application of Natural Cycle and Artificial Cycle after Descending Modulation in the Cycle of Vitrification Frozen Embryo Transfer

摘要:

〔摘 要〕 目的：探讨自然周期准备内膜与降调节后人工周期准备内膜在玻璃化冻融囊胚移植（FET）周期中的应用效果。 方法：选取 2021 年 1 月至 2021 年 12 月在徐州市妇幼保健院辅助生殖中心行玻璃化 FET 治疗且首次行单囊胚（囊胚质量 为 3BB 以上的优质囊胚）移植的 74 例患者，根据其内膜准备方案不同，分为 NC 组与 G–HRT 组，各 37 例。NC 组患者均 为进行自然周期内膜准备，G–HRT 组患者均为进行降调节后人工周期内膜准备，两组患者均为单囊胚移植，比较两组患者 的临床结局。 结果：G–HRT 组患者转化日内膜厚度为（10.22 ± 0.44）mm，与 NC 组的（10.18 ± 0.38）mm 比较，差异无 统计学意义（P ＞ 0.05）；G–HRT 组患者 A 型子宫内膜率为 59.46 %（22/37），与 NC 组的 59.46 %（22/37）比较，差异 无统计学意义（P ＞ 0.05）；两组患者的早期流产率、异位妊娠率比较，差异无统计学意义（P ＞ 0.05）；G–HRT 组患者 临床妊娠率显著高于 NC 组，差异具有统计学意义（P ＜ 0.05）。 结论：与自然周期相比，在玻璃化 FET 周期中，采用降 调节后人工周期进行子宫内膜准备，可改善子宫内膜容受性，提高临床妊娠率，是有效的玻璃化 FET 子宫内膜准备方案。

关键词:玻璃化冻融囊胚移植;内膜准备;自然周期;降调节后人工周期

Abstract:

〔Abstract〕 Objective To investigate the application effect of natural cycle endometrial preparation and artificial cycle endometrial preparation after descending modulation in the cycle of vitrification frozen embryo transfer (FET). Methods A total of 74 patients who underwent vitrification FET treatment and first received single blastocyst (high-quality blastocyst with a mass of more than 3BB) transplantation at the Assisted Reproduction Center of Xuzhou Maternal and Child Health Hospital from January 2021 to December 2021 were selected and divided into a NC group and a G-HRT group, 37 cases each, according to their different endometrial preparation plans. All patients in the NC group underwent natural cycle endometrial preparation, and all patients in the G-HRT group underwent artificial cycle endometrial preparation after descending modulation. Both groups underwent single blastocyst transplantation, and the clinical outcomes of the two groups were compared. Results The endometrial thickness of the G-HRT group was (10.22 ± 0.44) mm, compared with that of the NC group (10.18 ± 0.38) mm, there was no significant difference (P > 0.05). The rate of type A endometrium in the G-HRT group was 59.46% (22/37), compared with 59.46% (22/37) in the NC group, there was no significant difference (P > 0.05). There was no significant difference in the rate of early abortion and ectopic pregnancy between the two groups (P > 0.05). The clinical pregnancy rate of the G-HRT group was significantly higher than that of the NC group, and the difference was statistically significant (P < 0.05). Conclusion Compared with the natural cycle, in the vitrification FET cycle, the endometrial preparation using artificial cycle after descending modulation can improve the endometrial receptivity and increase the clinical pregnancy rate, which is an effective endometrial preparation scheme for vitrification FET.

Key words:Vitrification frozen embryo transfer; Endometrial preparation; Natural cycle; Artificial cycle after descending modulation