降调节后激素替代周期方案联合宫腔灌注HCG对反复种植失败患者妊娠结局的影响OA
Effect of hormone replacement protocol after down-regulation combined with intrauterine perfusion of HCG on pregnancy outcomes in patients with recurrent implantation failure
目的 探讨降调节后激素替代周期方案联合宫腔灌注人绒毛膜促性腺激素(HCG)对反复种植失败(RIF)患者的疗效.方法 回顾性分析2024年1月至2025年6月期间于我院生殖医学中心行冻融囊胚移植的90例RIF患者的病例资料.根据治疗方案不同分为对照组(采用降调节后激素替代周期方案进行子宫内膜准备,n=45)和研究组(在对照组基础上于移植前行宫腔灌注HCG,n=45).比较两组的子宫动脉血流参数[收缩期峰值流速(PSV)、舒张期峰值流速(EDV)、阻力指数(RI)]、子宫内膜血流分型、血清炎性因子[白细胞介素(IL)-6、IL-10、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)]水平,以及妊娠结局.结果 两组的一般资料比较无显著性差异(P＞0.05).胚胎移植后,研究组PSV、EDV、RI均显著低于对照组(P＜0.05);研究组子宫内膜血流分型中Ⅱ型+Ⅲ型比例显著高于对照组(P＜0.05);研究组IL-6、TNF-α水平显著低于对照组(P＜0.05),IL-10水平显著高于对照组(P＜0.05).两组间早期流产率比较无显著性差异(P＞0.05);研究组生化妊娠率显著低于对照组(11.11％vs.28.89％,P＜0.05),而囊胚种植率(40.00％vs.24.44％)、临床妊娠率(75.56％vs.46.67％)显著高于对照组(P＜0.05).结论 降调节后激素替代周期方案联合宫腔灌注HCG可改善RIF患者子宫动脉血流状态,优化子宫内膜血流分型,调节炎性因子水平,改善妊娠结局.
Objectives:To investigate the efficacy of hormone replacement protocol after down-regulation combined with intrauterine perfusion of human chorionic gonadotropin(HCG)in patients with recurrent implantation failure(RIF). Methods:A retrospective analysis was conducted on the clinical data of 90 RIF patients who underwent frozen-thawed blastocyst transfer in the Reproductive Medicine Center of Affiliated Maternal &Child Health Hospital of Nantong University from January 2024 to June 2025.According to the treatment regimens,the patients were divided into the control group(endometrial preparation with hormone replacement cycle after down-regulation,n=45)and the study group(same endometrial preparation as in the control group,with additional intrauterine HCG perfusion before embryo transfer,n=45).Uterine artery hemodynamic parameters[peak systolic velocity(PSV),end-diastolic velocity(EDV)and resistance index(RI),endometrial blood flow patterns],serum levels of inflammatory factors[interleukin(IL)-6,IL-10,interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)]and pregnancy outcomes were compared between the two groups. Results:There was no significant difference in the general baseline characteristics between the two groups(P＞0.05).After embryo transfer,the PSV,EDV,and RI in the study group were significantly lower than those in the control group(P＜0.05).The proportion of type Ⅱ+type Ⅲendometrial blood flow was significantly higher in the study group than that in the control group(P＜0.05).The serum levels of IL-6,TNF-α were significantly lower,while IL-10 significantly higher in the study group than those in the control group(P＜0.05).No significant difference was found in early miscarriage rate between the two groups(P＞0.05).Compared with that in the control group,the biochemical pregnancy rate in the study group was significantly lower(11.11％vs.28.89％,P＜0.05),while the blastocyst implantation rate(40.00％vs.24.44％)and clinical pregnancy rate(75.56％vs.46.67％)in the study group were significantly higher(P＜0.05). Conclusions:Hormone replacement protocol after down-regulation combined with intrauterine HCG perfusion can improve uterine artery blood flow,optimize endometrial blood flow patterns,regulate the inflammatory factor levels,and ultimately improve pregnancy outcomes in RIF patients.
朱洁;朱怡;沈亚
南通大学附属妇幼保健院生殖医学中心,南通 226000南通大学附属妇幼保健院生殖医学中心,南通 226000南通大学附属妇幼保健院生殖医学中心,南通 226000
医药卫生
降调节激素替代周期宫腔灌注人绒毛膜促性腺激素反复种植失败
DownregulationHormone replacement protocolIntrauterine infusionHuman chorionic gonadotropinRecurrent implantation failure
《生殖医学杂志》 2026 (8)
959-964,6
江苏省自然科学基金(BK20221417)南通市卫生健康委员会科研课题(QN2024045)
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