华中科技大学学报（医学版）
華中科技大學學報（醫學版）
화중과기대학학보（의학판）
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2015年
5期
578-581
,共4页
子宫内膜容受性%子宫内膜搔刮术%反复着床失败%体外受精-胚胎移植
子宮內膜容受性%子宮內膜搔颳術%反複著床失敗%體外受精-胚胎移植
자궁내막용수성%자궁내막소괄술%반복착상실패%체외수정-배태이식
endometrial receptivity%endometrial scratching%repeated implantation failure%in v itro fertilization and embryo transfer
目的：探讨子宫内膜搔刮术在反复移植失败（repeated implantation failure ，RIF）患者中的临床应用价值。方法选择2013年10月至2014年8月在华中科技大学同济医学院附属同济医院生殖中心就诊，因女方输卵管因素不孕（男方精液正常）行IVF‐ET治疗反复移植失败再次进入新的IVF‐ET 周期的患者，进行前瞻性随机对照研究。按病例编号把纳入标准的189例患者随机分成实验组（n＝96）和对照组（n＝93），实验组在取卵周期前1个月经周期月经来潮6 h内进行内膜搔刮，对照组不行内膜搔刮，比较胚胎移植后两组临床结局。结果两组患者年龄、不孕年限、体重指数、基础血清FS H、L H及P水平、Gn天数、Gn总量、获卵数、胚胎移植数、HCG日血清E2、P水平及 HCG日内膜厚度相比较，差异均无统计学意义（均 P＞0.05），实验组胚胎着床率、临床妊娠率及持续妊娠率均明显高于对照组，差异均有统计学意义（均 P＜0.01）。结论子宫内膜搔刮术可以改善子宫内膜容受性，提高RIF患者的临床妊娠率。
目的：探討子宮內膜搔颳術在反複移植失敗（repeated implantation failure ，RIF）患者中的臨床應用價值。方法選擇2013年10月至2014年8月在華中科技大學同濟醫學院附屬同濟醫院生殖中心就診，因女方輸卵管因素不孕（男方精液正常）行IVF‐ET治療反複移植失敗再次進入新的IVF‐ET 週期的患者，進行前瞻性隨機對照研究。按病例編號把納入標準的189例患者隨機分成實驗組（n＝96）和對照組（n＝93），實驗組在取卵週期前1箇月經週期月經來潮6 h內進行內膜搔颳，對照組不行內膜搔颳，比較胚胎移植後兩組臨床結跼。結果兩組患者年齡、不孕年限、體重指數、基礎血清FS H、L H及P水平、Gn天數、Gn總量、穫卵數、胚胎移植數、HCG日血清E2、P水平及 HCG日內膜厚度相比較，差異均無統計學意義（均 P＞0.05），實驗組胚胎著床率、臨床妊娠率及持續妊娠率均明顯高于對照組，差異均有統計學意義（均 P＜0.01）。結論子宮內膜搔颳術可以改善子宮內膜容受性，提高RIF患者的臨床妊娠率。
목적：탐토자궁내막소괄술재반복이식실패（repeated implantation failure ，RIF）환자중적림상응용개치。방법선택2013년10월지2014년8월재화중과기대학동제의학원부속동제의원생식중심취진，인녀방수란관인소불잉（남방정액정상）행IVF‐ET치료반복이식실패재차진입신적IVF‐ET 주기적환자，진행전첨성수궤대조연구。안병례편호파납입표준적189례환자수궤분성실험조（n＝96）화대조조（n＝93），실험조재취란주기전1개월경주기월경래조6 h내진행내막소괄，대조조불행내막소괄，비교배태이식후량조림상결국。결과량조환자년령、불잉년한、체중지수、기출혈청FS H、L H급P수평、Gn천수、Gn총량、획란수、배태이식수、HCG일혈청E2、P수평급 HCG일내막후도상비교，차이균무통계학의의（균 P＞0.05），실험조배태착상솔、림상임신솔급지속임신솔균명현고우대조조，차이균유통계학의의（균 P＜0.01）。결론자궁내막소괄술가이개선자궁내막용수성，제고RIF환자적림상임신솔。
Objective To explore the clinical application of endometrial scratching in patients with repeated implantation failure(RIF).Methods A total of 189 women with RIF who planned to undergo in vitro fertilization and embryo transfer(IVF‐ET)once again at the Reproductive Medicine Center of Tongji Hospital ,Huazhong University of Science and Technology ,be‐tween October 2013 and August 2014 ,were prospectively examined.These women were infertile due to tubal factors ,with their male partners having normal semen measurements.According to the case numbers ,the 189 patients were randomly divided into experimental group(n=96)and control group(n=93).In the experimental group ,endometrial scratching was conducted within 6 h of one menstrual cycle one month before oocyte retrieval ,while in control group ,no endometrial scratching was performed at that time.The outcomes of pregnancy were compared between the two groups after embryo transplantation.Results There was no statistical difference between the two groups in the patient age ,infertility duration ,body mass index(BMI) ,basal levels of follicle‐stimulating hormone(FSH) ,luteinizing hormone(LH) ,and progesterone(P) ,gonadotropin‐releasing hormone(Gn‐RH) injection days and doses ,the number of retrieved oocytes ,the number of transferred embryos ,the endometrial thickness and lev‐els of estradiol(E2 )and P on the day of HCG injection(P>0.05).The embryo implantation rate ,the clinical pregnancy rate and the ongoing pregnancy rate in the experimental group were much higher than those in the control group ,with statistically signif‐icant difference noted(P<0.01).Conclusion The endometrial scratching can improve the endometrial receptivity and enhance the clinical pregnancy rate of RIF patients.
