Pang Wen-Juan, Feng Xu, Wang Xiang, Wang Liang, Sun Ning-Xia
Reproductive Medicine Center, Second Affiliated Hospital of Naval Medical University, Shanghai, China.
Front Surg. 2023 Jan 6;9:994775. doi: 10.3389/fsurg.2022.994775. eCollection 2022.
Abnormal contraction of uterus and vascular smooth muscle lead to the formation of hypoxia environment in uterus. Abnormal contraction may be the basis of dysmenorrhea, endometriosis, infertility and other diseases. Phloroglucinol is a non-atropine and non-papaverine smooth muscle spasmolytic agent, which can reduce the abnormal contraction of uterine smooth muscle. This study investigated the effect of phloroglucinol on frozen embryo transfer in patients with endometriosis.
The data of patients with endometriosis who underwent a frozen embryo transfer in Shanghai Changzheng Hospital from August 2018 to August 2021, comprising a total of 453 cycles, were retrospectively analyzed. The patients for whom phloroglucinol was included over 217 cycles were administered intramuscully 40 mg phloroglucinol starting on the day of progesterone administration, then once daily up to day 7 after the embryo transfer. Those for whom phloroglucinol was not administered over 236 cycles were used as the control group. The age of 35 years was used as a boundary in this study to observe the pregnancy outcomes of patients in the two different age groups.
The biochemical pregnancy rate (63.13% vs. 51.27%), embryo implantation rate (44.64% vs. 33.60%), clinical pregnancy rate (59.64% vs. 48.30%), and live birth rate (52.99% vs. 36.86%) after the administration of phloroglucinol were higher than for patients in the control group, and the early abortion rate (7.75% vs. 20.18%) was also lower. The differences were statistically significant ( < 0.05). In particular, in the age group <35 years old, the embryo implantation rate (51.81% vs. 39.38%), clinical pregnancy rate (69.34% vs. 57.55%), and the live birth rate (63.50% vs. 44.60%) after phloroglucinol intervention rose significantly, and the abortion rate dropped (6.32% vs. 17.5%), indicating a statistically significant difference ( < 0.05). However, pregnancy outcomes showed no difference in the age group ≥35 years old ( > 0.05).
Continuous low-dose phloroglucinol pretreatment before and after frozen embryo transfer can improve both the clinical pregnancy and live birth rates and reduce the risk of abortion in younger infertile patients with endometriosis.
子宫及血管平滑肌异常收缩导致子宫内缺氧环境形成。异常收缩可能是痛经、子宫内膜异位症、不孕等疾病的发病基础。间苯三酚是一种非阿托品、非罂粟碱类平滑肌解痉剂，可减轻子宫平滑肌的异常收缩。本研究探讨间苯三酚对子宫内膜异位症患者冻融胚胎移植的影响。
回顾性分析2018年8月至2021年8月在上海长征医院接受冻融胚胎移植的子宫内膜异位症患者的数据，共453个周期。纳入间苯三酚治疗的217个周期患者，从黄体酮给药日开始肌肉注射40mg间苯三酚，然后每天1次，直至胚胎移植后第7天。未使用间苯三酚治疗的236个周期患者作为对照组。本研究以35岁为界，观察两个不同年龄组患者的妊娠结局。
使用间苯三酚后，生化妊娠率（63.13%对51.27%）、胚胎着床率（44.64%对33.60%）、临床妊娠率（59.64%对48.30%）和活产率（52.99%对36.86%）均高于对照组患者，早期流产率（7.75%对20.18%）也较低。差异具有统计学意义（<0.05）。特别是，在<35岁年龄组中，间苯三酚干预后的胚胎着床率（51.81%对39.38%）、临床妊娠率（69.34%对57.55%）和活产率（63.50%对44.60%）显著上升，流产率下降（6.32%对17.5%），差异具有统计学意义（<0.05）。然而，在≥35岁年龄组中妊娠结局无差异（>0.05）。
冻融胚胎移植前后持续低剂量间苯三酚预处理可提高年轻子宫内膜异位症不孕患者的临床妊娠率和活产率，并降低流产风险。
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