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目的探讨宫腔粘连术后影响辅助生殖患者冻融胚胎移植(FET)临床妊娠率的临床因素。方法回顾性分析2011年3月至2015年6月于南京医科大学附属南京妇幼保健院生殖中心因宫腔粘连行宫腔镜下粘连电切或分离术,择期行冻融胚胎移植130个周期辅助生殖患者的病历资料,根据结局分为妊娠组(G1=46例)及非妊娠组(G2=84例),比较两组的一般情况、术后移植间隔时间、移植胚胎数、优质胚胎数及转化日子宫内膜厚度进一步比较妊娠组(Gl=42例)及非妊娠组(G2=80例)口服雌激素剂量及用药天数的差异此外分析不同用药类型(补佳乐组N1=80例,芬吗通组N2=42例)、不同优胚数目移植组临床妊娠率的差异,以期进一步指导临床治疗。结果 G1组与G2组的一般情况、术后移植间隔时间、移植胚胎数差异均未见统计学意义(均P>0.05)。GI组移植优质胚胎数(1.83±0.570枚)多于G2组(1.30±0.847枚)(t=4.231,P<0.05);移植2枚优质胚胎组临床妊娠率分别高于0枚、1枚优质胚胎组(X~2=11.289,P=0.001;X~2=6.605,P=0.013)。G1组转化日子宫内膜厚度(7.76±1.214mm)高于G2组(6.75±1.131 mm),差异有统计学意义(t=4.725,P<0.05)。G2组口服雌激素剂量高于G1组(t=-2.675,P<0.05),用药天数相近(P>0.05),N1组不孕年限长于N2组(t=2.516,P<0.05),余项差异均无统计学意义(均P>0.05)。结论对于宫腔粘连术后行冻融胚胎移植的患者,转化日子宫内膜厚度及移植优质胚胎数是影响其妊娠结局的重要因素,移植2枚优质胚胎能获得相对更高的临床妊娠率。
Objective To investigate the clinical factors influencing the clinical pregnancy rate of frozen-thawed embryo transfer (FET) in assisted reproductive patients after intrauterine adhesions. Methods Retrospective analysis of March 2011 to June 2015 at Nanjing Medical University Affiliated Nanjing Maternal and Child Health Hospital Reproductive Center due to intrauterine adhesions hysteroscopic resection or isolation, elective frozen-thawed embryo transfer 130 cycles assisted reproductive Patient’s medical history data were divided into pregnancy group (G1 = 46 cases) and non-pregnancy group (G2 = 84 cases) according to the outcome. The general situation, the time of transplantation, the number of embryos transferred, Day endometrial thickness was further compared with the control group (Gl = 42 cases) and non-pregnancy group (G2 = 80 cases) oral estrogen dose and the number of days of medication differences in addition analysis of different drug types (n Mok Tong group N2 = 42 cases), the number of different excellent embryo implantation clinical differences in clinical pregnancy rates, with a view to further guide clinical treatment. Results There was no significant difference between the G1 group and the G2 group in general, postoperative transplantation interval and the number of embryos transferred (all P> 0.05). The number of high quality embryos (1.83 ± 0.570) in GI group was significantly higher than that in G2 group (1.30 ± 0.847) (t = 4.231, P <0.05). The pregnancy rates of two high quality embryos were higher than 0, Embryos group (X ~ 2 = 11.289, P = 0.001; X ~ 2 = 6.605, P = 0.013). The endometrial thickness of the G1 group on day of transformation (7.76 ± 1.214mm) was higher than that of G2 group (6.75 ± 1.131mm), the difference was statistically significant (t = 4.725, P <0.05). The dose of estrogen in group G2 was higher than that in group G1 (t = -2.675, P <0.05), and the days of treatment were similar (P> 0.05). The duration of infertility in group N1 was longer than that in group N2 (t = 2.516, There was no significant difference (all P> 0.05). Conclusion For patients with intrauterine adhesions who underwent freeze-thawed embryo transfer, the endometrial thickness on the conversion day and the number of high quality embryos transferred are important factors affecting the outcome of pregnancy. Two high quality embryos transferred could achieve a relatively higher clinical pregnancy rate.