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目的探讨宫腔粘连术后内膜生长不良患者应用小剂量尿促性腺激素(h MG)联合芬吗通阴道放药对冻融胚胎移植妊娠结局的影响。方法回顾性分析2012年1月-2016年5月在第二军医大学长海医院生殖医学中心因宫腔粘连术后内膜生长不良择期行冷融胚胎移植的患者资料共38个周期。根据内膜准备方案随机分为两组:A组口服补佳乐组(22例),B组小剂量hMG+芬吗通阴道给药组(16例),比较各组患者年龄、不孕年限、体质量指数、转化日内膜厚度、冷冻胚胎复苏率、优质胚胎率、移植胚胎数、内膜转化日血清雌二醇(E_2)浓度、妊娠率、早期流产率及周期取消率的差异。结果 B组患者内膜增厚值及血清E_2水平均明显高于A组,差异有统计学意义(P<0.05)。B组患者临床妊娠率较A组明显增加,差异有统计学意义(P<0.05);两组患者年龄、不孕年限、体质量指数、平均移植胚胎数、移植优质胚胎数、冷冻胚胎复苏率、流产率及周期取消率比较,差异无统计学意义(P>0.05)。结论宫腔粘连术后患者冻融胚胎移植中,采用小剂量hMG促排卵联合芬吗通阴道给药,能增加内膜厚度,提高妊娠率和着床率。
Objective To investigate the effect of h MG combined with fentanyl vaginal delivery on pregnancy outcomes of frozen-thawed embryo transfer in patients with endometrial dysplasia after intrauterine adhesions. Methods A retrospective analysis was performed on 38 patients who underwent cold-adapted embryo transfer in the Department of Reproductive Medicine, Changhai Hospital, Second Military Medical University from January 2012 to May 2016. According to the protocol of endomembrane preparation, the patients were divided into two groups at random: group A (n = 22), group B (hMG + fentanyl via vaginal administration), group B, age, duration of infertility, Body mass index, endometrial thickness at the conversion day, frozen embryo recovery rate, high quality embryo rate, number of embryos transferred, serum estradiol (E2) concentration on endometrial transformation day, pregnancy rate, abortion rate and cycle cancellation rate. Results Intimal thickening and serum E 2 levels in group B were significantly higher than those in group A, the difference was statistically significant (P <0.05). The clinical pregnancy rate in group B was significantly higher than that in group A (P <0.05). The age, the duration of infertility, the body mass index, the average number of transplanted embryos, the number of transplanted high quality embryos, the rate of frozen embryo recovery , Abortion rate and cycle cancellation rate, the difference was not statistically significant (P> 0.05). Conclusion In patients with intrauterine adhesions frozen-thawed embryo transfer, the use of small doses of hMG ovulation combined with fentanyl vaginal administration, can increase the thickness of the intima and improve the pregnancy rate and implantation rate.