| 515 | 23 | 77 |
| 下载次数 | 被引频次 | 阅读次数 |
目的探讨17β-雌二醇及生长激素(GH)在薄型子宫内膜患者的治疗应用情况。方法回顾性分析前次补佳乐替代周期因子宫内膜薄而取消周期的66名患者,改用17β-雌二醇或加用生长激素再次准备内膜的80个冻融胚胎移植(FET)周期的临床资料。根据内膜准备方案分为17β-雌二醇组、17β-雌二醇+GH组、补佳乐+GH组,分析各组年龄、不孕年限、移植胚胎数、优胚率、不孕类型构成等基本情况和移植日血清E2水平、移植日内膜厚度、生化妊娠率、临床妊娠率等临床结局情况。结果三组患者移植日内膜厚度较既往失败周期均有提高(分别为8.76±0.35mm vs.5.65±0.23mm,7.78±0.19mm vs.5.23±0.15mm,8.31±0.24mm vs.5.91±0.19mm),差异均有统计学意义(P<0.01);17β-雌二醇+GH组移植日内膜厚度虽较17β-雌二醇组薄(7.78±0.19mm vs.8.76±0.35mm)、但临床妊娠率更高(54.3%vs.18.2%),差异均有统计学意义(P<0.01)。结论三种不同方案均能改善补佳乐替代周期中薄型子宫内膜患者子宫内膜厚度及临床结局,其中可能17β-雌二醇+GH是较为理想的替代方案,但仍需更大样本量的研究验证。
Abstract：[1]Okohue JE,Onuh SO,Ebeigbe P,et al.The effect of endometrial thickness on in vitro fertilization(IVF)-embryo transfer/intracytoplasmic sperm injection(ICSI)outcome[J].Afr J Reprod Health,2009,13:113-121.
[2]El-Toukhy T,Coomarasamy A,Khairy M,et al.The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles[J].Fertil Steril,2008,89:832-839.
[3]王海燕,孙林,王磊,等.芬吗通在氯米酚促排卵周期子宫内膜薄患者中的应用[J].生殖医学杂志,2015,24:200-203.
[4]赵诗艺,刘英,杨晓葵,等.薄型子宫内膜冻融胚胎移植周期中应用雌二醇/雌二醇地屈孕酮的疗效观察[J].实用妇产科杂志,2015,31:270-273.
[5]王佩玉,赵军招,金聪聪,等.芬吗通和补佳乐在冻融胚胎移植周期中的应用比较[J].温州医科大学学报,2015,45:36-39,44.
[6]Noel S,Herman A,Johnson GA,et al.Ovine placental lactogen specificially binds to endometrial glands of the ovine uterus[J].Biol Reprod,2003,68:772-780.
[7]项云改,谭丽,赵冬梅,等.生长激素对子宫内膜发育不良患者内膜容受性及体外受精-胚胎移植临床结局的影响[J].医药论坛杂志,2011,32:56-58,60.
[8]陈华,孙海翔,王慧焱,等.自然周期与替代周期准备内膜对冷冻胚胎移植结局的影响[J].南京医科大学学报(自然科学版),2010,30:245-248.
[9]Richter KS,Bugge KR,Bromer JG,et al.Relationship between endometrial thickness and embryo implantation,based on 1,294cycles of in vitro fertilization with transfer of two blastocyst-stage embryos[J].Fertil Steril,2007,87:53-59.
[10]Mikolajczyk M,Skrzypczak J.Endometrial receptivity-can it be diagnosed and controlled?And why does it matter?[J].Ginekol Pol,2014,85:149-153.
[11]Yoeli R,Ashkenazi J,Orvieto R,et al.Significance of increased endometrial thickness in assisted reproduction technology treatments[J].J Assist Reprod Genet,2004,21:285-289.
[12]McWilliams GD,Frattarelli JL.Changes in measured endometrial thickness predict in vitro fertilization success[J].Fertil Steril,2007,88:74-81.
[13]孙林,王磊,柯雪,等.芬吗通在冻融周期子宫内膜发育不良患者中的应用[J].生殖医学杂志,2014,23:42-47.
[14]陈蓉,吴丽萍.激素补充治疗中不同雌激素的特点[J].中国计划生育和妇产科,2012,4:13-16.
[15]李华,李蓉,刘洋,等.芬吗通改善反复胚胎移植失败患者子宫内膜血流和提高妊娠率的研究[J].生殖医学杂志,2014,23:37-41.
[16]Koos RD.Minireview:Putting physiology back into estrogens’mechanism of action[J].Endocrinology,2011,152:4481-4488.
[17]Lukassen HG,Joosten I,van Cranenbroek B,et al.Hormonal stimulation for IVF treatment positively affects the CD56bright/CD56dim NK cell ratio of the endometrium during the window of implantaion[J].Mol Hum Reprod,2004,10:513-520.
[18]唐慧珍,高士友,邓朝晖,等.三种内膜准备方案在冻融胚胎移植中的结局分析[J].生殖医学杂志,2015,24:236-239.
[19]Nishiyama K,Sugimoto T,Kaji H,et al.Stimulatory effect of growth hormone on bone resorption and osteoclast differentiation[J].Endocrinology,1996,137:35-41.
[20]Bannink EM,van der Palen RL,Mulder PG,et al.Long-term follow-up of GH-treated girls with Turner syndrome:BMI,blood pressure,body proportions[J].Horm Res,2009,71:336-342.
[21]Maffei L,Rochira V,Zirilli L,et al.A novel compound heterozygous mutation of the aromatase gene in an adult man:reinforced evidence on the relationship between congenital oestrogen deficiency,adiposity and the metabolic syndrome[J].Clin Endocrinol(Oxf),2007,67:218-224.
[22]Wolthers T,Hoffman DM,Nugent AG,et al.Oral estrogen antagonizes the metabolic actions of growth hormone in growth hormone-deficient women[J].Am J Physiol Endocrinol Metab,2001,281:E1191-1196.
[23]Kelly JJ,Rajkovic IA,O’Sullivan AJ,et al.Effects of different oral oestrogen formulations on insulin-like growth factor-1,growth hormone and growth hormone binding protein in post-menopausal women[J].Clin Endocrinol(Oxf),1993,39:561-567.
[24]马新想,孙莹璞,苏迎春,等.生长激素在子宫内膜发育不良中的作用[J].现代妇产科进展,2009,18:330-332.
[25]李秀清,高小琴,韩雪黎,等.多次胚胎移植失败生长激素对子宫内膜及内膜血流的影响[J].实用医技杂志,2014,21:1333-1335.
基本信息:
中图分类号:R714.8
引用信息:
[1]凌丹丹,施晓波.17β-雌二醇及生长激素在薄型子宫内膜患者冷冻胚胎移植内膜准备中的作用[J].生殖医学杂志,2016,25(01):72-76.
2016-01-15
2016-01-15