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低剂量 hCG 在反复着床失败患者 FET 周期中的疗效。

Efficacy of low-dose hCG on FET cycle in patients with recurrent implantation failure.

机构信息

Navy Clinical Medical School, Anhui Medical University, Hefei, China.

The Fifth School of Clinical Medicine, Anhui Medical University, Hefei, China.

出版信息

Front Endocrinol (Lausanne). 2022 Nov 23;13:1053592. doi: 10.3389/fendo.2022.1053592. eCollection 2022.

Abstract

OBJECTIVE

To study patients' new treatment methods and mechanisms of repeated implantation failure.

DESIGN

A retrospective study.

SETTING

fertilization (IVF) unit in a Three-A hospital.

PATIENTS

Ninety-three patients with repeated implantation failure in IVF and embryo transfer.

INTERVENTIONS

the luteal phase support.

MAIN OUTCOME MEASURES

According to whether human chorionic gonadotropin(HCG) was added, the two groups were divided into an observation group and a control group, and the clinical outcomes of the two groups were compared. Furthermore, 20 patients were selected for whole exome sequencing to investigate the mechanism.

RESULTS

The observation group's clinical pregnancy rate and live birth rate were significantly higher than those in the control group (). Functional enrichment analysis showed that these genes were significantly enriched in embryo implantation or endometrial receptivity processes, such as microtubule-based movement, NABA CORE MATRISOME, superoxide anion generation, protein localization to vacuole, extracellular matrix organization, fertilization, microtubule-based transport, cell junction organization, microtubule cytoskeleton organization. Furthermore, variants detected in these pathway genes were missense mutations that affect the protein's biological activity but do not effectuate its inactivation.

CONCLUSIONS

Adding HCG in the luteal phase might improve the clinical pregnancy and live birth rates in RIF patients. The potential pathogenesis of RIF genetic level may be caused by microtubule-based movement, extracellular matrix organization, and the Superoxide Anion generation pathway.

摘要

目的

研究反复种植失败患者的新治疗方法和机制。

设计

回顾性研究。

地点

某三甲医院生殖医学中心。

对象

93 例行体外受精-胚胎移植反复种植失败患者。

干预措施

黄体支持。

主要观察指标

根据是否加用人绒毛膜促性腺激素(HCG)将两组患者分为观察组和对照组,比较两组患者的临床结局。进一步选取 20 例行全外显子组测序患者,探讨其发生机制。

结果

观察组临床妊娠率和活产率均显著高于对照组()。功能富集分析发现,这些基因在胚胎着床或子宫内膜容受性过程中显著富集,如微管运动、NABA CORE MATRISOME、超氧阴离子生成、蛋白定位于液泡、细胞外基质组织、受精、微管依赖的运输、细胞连接组织、微管细胞骨架组织等。此外,这些通路基因中检测到的变异为影响蛋白生物学活性但不使其失活的错义突变。

结论

黄体期添加 HCG 可能提高 RIF 患者的临床妊娠率和活产率。RIF 遗传水平的潜在发病机制可能与微管运动、细胞外基质组织和超氧阴离子生成途径有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0541/9726871/fdd6bb5b0377/fendo-13-1053592-g001.jpg

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