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薄型子宫内膜患者的累积活产率:一项真实世界的单中心经验。

Cumulative Live Birth Rate in Patients With Thin Endometrium: A Real-World Single-Center Experience.

机构信息

Henan Province Key Laboratory for Reproduction and Genetics, Reproductive Medical Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Endocrinol (Lausanne). 2020 Sep 4;11:469. doi: 10.3389/fendo.2020.00469. eCollection 2020.

Abstract

Studies have shown that patients with a thin endometrial thickness (EMT < 7 or 8 mm) during IVF/ICSI tend to have adverse pregnancy outcomes, and this has caused much anxiety to both patients and physicians when confronted with a thin EMT. From January 2015 to December 2018, patients with a thin EMT < 7 mm on the day of hCG administration during their first GnRH agonist IVF/ICSI cycle were included. According to the hysteroscopy results, patients were classified into totally normal (Group A), normal with a specific abnormality (Group B), and adhesion before transfer (Group C). For the 245 patients included, approximately 60% of the thin EMT cases were the result of an intrauterine operation. CLBR was 35.45% (67/189) in this group of patients. In regard to CLBR, there were significant differences among these three uterus condition groups irrespective of the number of oocytes retrieved (28.57 vs. 10.00 vs. 4.76%, = 0.12 in oocyte ≤5; 61.36 vs. 44.67 vs. 23.63%, = 0.00 in oocyte >5). In binary logistic regression analysis, age (OR = 0.09, = 0.03), number of embryos available (OR = 1.71, = 0.00), and uterine condition (OR = 6.77, = 0.00 for group A; OR = 2.55, = 0.04 for group B; Reference = group C), were significantly associated with CLBR. However, EMT and endometrial pattern had no impact on CLBR. An intrauterine operation was the main reason for a thin EMT. Thin EMT patients with a normal uterine cavity and endometrium had a significantly better CLBR compared with those with adhesions before transfer.

摘要

研究表明,在体外受精/卵胞浆内单精子注射(IVF/ICSI)中,子宫内膜厚度薄(EMT<7 或 8mm)的患者往往有不良的妊娠结局,这使得患者和医生在面对薄 EMT 时感到非常焦虑。本研究回顾性分析了 2015 年 1 月至 2018 年 12 月在 GnRH 激动剂 IVF/ICSI 周期中 hCG 日 EMT<7mm 的患者。根据宫腔镜结果,将患者分为完全正常(A 组)、正常伴特定异常(B 组)和转移前粘连(C 组)。在纳入的 245 例患者中,大约 60%的薄 EMT 病例是宫内手术的结果。该组患者的 CLBR 为 35.45%(67/189)。在 CLBR 方面,无论取卵数如何,这三组子宫情况之间均有显著差异(28.57%vs.10.00%vs.4.76%,=0.12,取卵数≤5;61.36%vs.44.67%vs.23.63%,=0.00,取卵数>5)。二元逻辑回归分析显示,年龄(OR=0.09,=0.03)、胚胎数(OR=1.71,=0.00)和子宫状况(OR=6.77,=0.00,A 组;OR=2.55,=0.04,B 组;参考 C 组)与 CLBR 显著相关。然而,EMT 和子宫内膜模式对 CLBR 没有影响。宫内手术是 EMT 变薄的主要原因。与转移前粘连的患者相比,宫腔和子宫内膜正常的薄 EMT 患者 CLBR 明显更好。

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