国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2021, Vol. 40 ›› Issue (1): 18-22.doi: 10.12280/gjszjk.20200359

• 论著 • 上一篇    下一篇

宫腔灌注粒细胞集落刺激因子对薄型子宫内膜冻融胚胎移植的影响

张丽(), 葛丽娜, 梁俊霞, 张玉, 刘效群, 闫蒙, 韩省华   

  1. 050071 石家庄,河北省计划生育科学技术研究院,国家卫健委计划生育与优生重点实验室,河北省生殖医学重点实验室
  • 收稿日期:2020-06-23 出版日期:2021-01-15 发布日期:2021-01-21
  • 通讯作者: 张丽 E-mail:zhangli-sa@163.com
  • 基金资助:
    河北省医学适用技术跟踪项目(G2019062)

Effect of Intrauterine Perfusion of Granulocyte Colony-Stimulating Factor on Treatment of Thin Endometrium During Frozen-Thawed Embryo Transfer Cycles

ZHANG Li(), GE Li-na, LIANG Jun-xia, ZHANG Yu, LIU Xiao-qun, YAN Meng, HAN Sheng-hua   

  1. Hebei Research Institute for Family Planning, NHC Key Laboratory for Family Planning and Healthy, Hebei Key Laboratory of Reproductive Medicine, Shijiazhuang 050071, China
  • Received:2020-06-23 Published:2021-01-15 Online:2021-01-21
  • Contact: ZHANG Li E-mail:zhangli-sa@163.com

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摘要：

目的:回顾性分析宫腔灌注粒细胞集落刺激因子（granulocyte colony-stimulating factor,G-CSF）对薄型子宫内膜患者冻融胚胎移植（frozen-thawed embryo transfer,FET）结局的影响。方法:选取2018年1月—2020年2月在河北省计划生育科学技术研究院和河北省生殖医院拟行FET治疗的薄型子宫内膜患者。对符合纳入、排除剔除标准的64例患者进行宫腔灌注G-CSF治疗。比较宫腔灌注后、宫腔灌注前以及同一患者前一个激素替代治疗（hormone replacement therapy,HRT）周期（前一周期）的子宫内膜厚度、形态、内膜血流、子宫动脉血流参数,及灌注周期和灌注前周期的取消率、临床妊娠率和种植率。结果:宫腔灌注G-CSF后子宫内膜厚度分别与灌注前、前一周期比较,差异均有统计学意义（均P<0.05）;而宫腔灌注G-CSF后子宫PI值、RI值和S/D比值分别与灌注前、前一周期比较差异均无统计学意义（P>0.05）。宫腔灌注后A型形态子宫内膜比例25.0%（16/64）较灌注前35.90%（23/64）和前一周期34.4%（22/64）降低,但差异均无统计学意义（均P>0.05）。宫腔灌注后Ⅱ型血流子宫内膜比例[75.00%（48/64）]较灌注前[26.56%（17/64）]和前一周期[18.75%（12/64）]均升高,差异均有统计学意义（均P<0.05）。灌注周期较前一周期的周期取消率降低（20.3% vs. 37.5%）,临床妊娠率（60.8% vs. 40.0%）和种植率（38.5% vs. 24.4%）增高,差异均有统计学意义（均P<0.05）。结论:宫腔灌注G-CSF能够改善薄型子宫内膜患者的厚度,降低周期取消率,提高患者的妊娠率和种植率。

关键词: 粒细胞集落刺激因子, 胚胎移植, 子宫内膜, 妊娠结局, 冻融胚胎移植

Abstract:

Objective: To retrospectively analyze the effect of intrauterine perfusion of granulocyte colony-stimulating factor (G-CSF) on the outcome of frozen-thawed embryo transfer (FET) in patients with thin endometrium.Methods: From January 2018 to February 2020, patients with thin endometrium who were scheduled to undergo FET treatment in Hebei Research Institute for Family Planning and Hebei Reproductive Hospital were selected. 64 patients who met the inclusion criteria were treated with intrauterine perfusion of G-CSF. Endometrial thickness, morphology, endometrial blood flow, uterine artery blood flow parameters, and cancellation rate, clinical pregnancy rate and implantation rate in the post-/pre-perfusion cycle and the last cycle were compared with those in the previous hormone replacement therapy (HRT) cycle.Results: There was no difference in the endometrial thickness after intrauterine infusion of G-CSF between the before perfusion and the last cycles (P<0.05). The differences in the uterine PI value, RI value and S/D ratio after intrauterine infusion of G-CSF were not significant between the before perfusion and the last cycles (all P>0.05). The proportion of type A morphological endometrium after intrauterine perfusion was 25.0% (16/64), lower than that in the before perfusion [35.90% (23/64)] and the last cycles [34.4% (22/64)], although the difference was not statistically significant (P>0.05). The proportion of endometrium with type Ⅱ blood flow after intrauterine perfusion [75.00% (48/64)] was higher than that in the before perfusion [26.56% (17/64)] and the last cycles [18.75% (12/64)], and the difference was statistically significant (P<0.05). The abolition rate of perfusion cycle was lower than that of the last cycle (20.3% vs. 37.5%), and the clinical pregnancy rate (60.8% vs. 40.0%) and implantation rate (38.5% vs. 24.4%) were increased (both P<0.05).Conclusions: Intrauterine infusion of G-CSF can improve the endometrial thickness of patients with thin endometrium, reduce the cycle cancellation rate, and improve the pregnancy rate and implantation rate.

Key words: Granulocyte colony-stimulating factor, Embryo transfer, Endometrium, Pregnancy outcome, Frozen embryo transfer