子宫内膜息肉摘除术后两种内膜准备方案临床结局的比较

doi:10.3969/j.issn.2095-9400.2020.06.008

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摘要目的：比较子宫内膜息肉摘除术后，应用促性腺激素释放激素激动剂降调节激素替代治疗（GnRH-a+HRT）和激素替代治疗（HRT）进行内膜准备的临床结局。方法：回顾性分析2018年7月至2019年7月在温州医科大学附属第二医院生殖中心子宫内膜息肉摘除术后3个月内行HRT或GnRH-a+HRT方案的患者，比较2组患者的基本情况，囊胚移植情况以及妊娠结局。结果：HRT组患者56例，取消移植1例；GnRH-a+HRT组患者53例，无周期取消。2组患者基本情况差异无统计学意义（P＞0.05）；2组不孕因素差异无统计学意义（P＞0.05）；2组间囊胚移植日子宫内膜情况、囊胚移植情况差异无统计学意义（P＞0.05）；2组间HCG阳性率、胚胎着床率、临床妊娠率、多胎妊娠率与早期流产率差异无统计学意义（P＞0.05）。结论：HRT方案与GnRH-a+HRT方案均能获得较好的妊娠结局。

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	徐嘉聆
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	习海涛
	赵军招

关键词 ：促性腺激素释放激素激动剂, 激素替代治疗, 子宫内膜息肉

Abstract：Objective: To investigate the potential of gonadotropin-releasing hormone agonist down-regulated hormone replacement therapy (GnRH-a+HRT) and hormone replacement therapy (HRT) for patients after endometrial polypectomy. Methods: This study analyzed 109 patients with endometrial polypectomy in three months who underwent frozen-thawed blastocyst transfer within three months after endometrial polypectomy at Reproductive Center of the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from July 2018 to July 2019. The basic conditions of the patients, blastocyst transfer outcomes and pregnancy outcomes between two groups were compared. Results: A total of 56 patients were enrolled in the HRT group and one of them canceled the transplant and 53 patients were enrolled in the GnRH-a+HRT group. There was no significant differences between the two groups of patients in their basic conditions. Though the HRT group had lower rate of the specific infertility factor than the GnRH-a+HRT group, there was no statistically difference. No difference was found in the conditons of endometrial and blastocysts transplants between the two gruops. Compared to the HRT group, the positive rate of HCG, the rate of clinical pregnancy, the rate of embroy implantation was higher in GnRH-a+HRT group but no significant difference were found. There were no difference between the groups in the early abortion rate and multiple pregnancy. Conclusion: Both GnRH-a+HRT and HRT could achieve great pregnancy outcomes and each has its own advantages and disadvantages. For patients with endometriosis, adenomyosis, intramural myomas, polycystic ovary syndrome or hydrosalpinxs, it is suggested that the GnRH-a+HRT be considered the first choice.

Key words： gonadotropin-releasing hormone agonist hormone replacement therapy endometrial polyps

收稿日期: 2019-10-16

基金资助:浙江省自然科学基金资助项目（LQ16H040002）；温州市生殖遗传重点创新团队项目（C20170007）。

通讯作者: 赵军招，教授，主任医师，硕士生导师，Email：z.joyce08@163.com。

作者简介: 徐嘉聆（1993-），女，浙江温州人，硕士生。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2020.06.008 或 https://xb.wmu.edu.cn/CN/Y2020/V50/I6/471

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