Tang Zhixia, Hong Mingyun, He Fang, Huang Dayan, Dai Zhijun, Xuan Henghua, Zhang Hong, Zhu Weipei
Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Reproductive Medicine Center, Maternity and Child Health Hospital of Anhui Province, The Maternal and Child Health Clinical College, Anhui Medical University, Hefei, China.
J Obstet Gynaecol Res. 2020 Mar;46(3):451-458. doi: 10.1111/jog.14193. Epub 2020 Jan 30.
To explore the clinical effect of endometrial injury (EI) on the third day of the menstrual cycle before frozen-thawed embryo transfer (frozen-thawed ET) on patients experienced two or more implantation failures.
A total of 200 patients who suffered at least two failed hormone-replacement therapies and frozen-thawed ET were randomly divided into two groups: EI group and control group (n = 100 in each group). Patients in the EI group received local EI with a Pipelle catheter on the third day of the menstrual cycle before frozen-thawed ET. Primary outcomes were live birth, clinical pregnancy and implantation rates. Secondary outcomes were biochemical, multiple and ectopic pregnancy rates and abortion rates.
The rate of live birth in EI group (51.00%) was significantly higher than that of control group (36.00%) (P = 0.032). Clinical pregnancy and implantation rates in EI group were significantly higher comparing to control group (64.00% vs 48.00%, P = 0.023 and 46.74% vs 30.11%, P = 0.001). The rate of multiple pregnancy in EI group (37.50%) was significantly higher than that of control group (18.75%) (P = 0.031). No significant difference in ectopic pregnancy rate and abortion rate was observed between EI group and control group.
Applying EI to patients experienced two or more implantation failures on the third day of the menstrual cycle before frozen-thawed ET can improve clinical outcomes.
探讨在冻融胚胎移植（冻融ET）前月经周期第三天进行子宫内膜损伤（EI）对经历两次或更多次植入失败患者的临床效果。
总共200例至少经历两次激素替代疗法失败和冻融ET失败的患者被随机分为两组：EI组和对照组（每组n = 100）。EI组患者在冻融ET前月经周期的第三天接受用Pipelle导管进行的局部EI。主要结局为活产、临床妊娠和植入率。次要结局为生化妊娠、多胎妊娠和异位妊娠率以及流产率。
EI组的活产率（51.00%）显著高于对照组（36.00%）（P = 0.032）。EI组的临床妊娠和植入率与对照组相比显著更高（64.00%对48.00%，P = 0.023；46.74%对30.11%，P = 0.001）。EI组的多胎妊娠率（37.50%）显著高于对照组（18.75%）（P = 0.031）。EI组和对照组之间在异位妊娠率和流产率方面未观察到显著差异。
在冻融ET前月经周期第三天对经历两次或更多次植入失败的患者应用EI可改善临床结局。
