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薄型子宫内膜患者胚胎移植后成功活产的病例报告

A Case Report of Successful Live Pregnancy Following Embryo Transfer in a Thin Endometrium.

作者信息

Ali Jijisha, Magray Shazia, Ahmed Eman, Talo Sami

机构信息

Obstetrics and Gynaecology, Mediclinic Welcare Hospital, Mediclinic Middle East, Dubai, ARE.

Reproductive Medicine and Infertility, Bourn Hall Fertility Centre, Mediclinic Middle East, Dubai, ARE.

出版信息

Cureus. 2024 Aug 7;16(8):e66363. doi: 10.7759/cureus.66363. eCollection 2024 Aug.

Abstract

Managing a thin endometrium is a common challenge in assisted reproductive treatments. The thickness of the endometrium is crucial for embryo implantation, with younger patients generally having higher success rates even with a thinner lining. A frozen embryo transfer cycle often allows for a more thorough assessment of the endometrium compared to a fresh transfer. We present a case of a 36-year-old woman who presented to our fertility center with primary infertility for six years. Despite having regular menstrual cycles, her endometrial thickness consistently measured between 5 and 6.0 mm on ultrasonography. She underwent ovarian stimulation using an antagonist protocol, resulting in the retrieval of oocytes and the freezing of three embryos. However, three frozen embryo transfer cycles were cancelled due to inadequate endometrial thickness (ranging from 4.3 to 5.2 mm). In the fourth cycle, she was treated with gonadotropins with the goal of achieving two to three follicles and improved endometrial thickness. Triggering was performed on day 15, followed by the transfer of one frozen embryo at an endometrial thickness of 5.7 mm. Her beta-human chorionic gonadotropin (hCG) level was positive, with an initial value of 136.9 mIU/mL, and she subsequently delivered a healthy baby. This case highlights the challenges of managing a thin endometrium in assisted reproductive techniques. Through persistent efforts and tailored treatment protocols, a successful live birth was achieved despite recurrent thin endometrium. This case underscores the importance of individualized treatment strategies in overcoming endometrial challenges in infertility treatments.

摘要

在辅助生殖治疗中,处理薄型子宫内膜是一个常见的挑战。子宫内膜的厚度对于胚胎着床至关重要,年轻患者即使内膜较薄通常也有较高的成功率。与新鲜胚胎移植相比,冷冻胚胎移植周期往往能对子宫内膜进行更全面的评估。我们报告一例36岁女性,因原发性不孕六年前来我们的生育中心就诊。尽管月经周期规律,但超声检查显示她的子宫内膜厚度始终在5至6.0毫米之间。她采用拮抗剂方案进行卵巢刺激,成功获取了卵母细胞并冷冻了三个胚胎。然而,由于子宫内膜厚度不足(4.3至5.2毫米),三次冷冻胚胎移植周期均被取消。在第四个周期,她接受了促性腺激素治疗,目标是获得两到三个卵泡并改善子宫内膜厚度。在第15天进行扳机注射,随后在子宫内膜厚度为5.7毫米时移植了一枚冷冻胚胎。她的β-人绒毛膜促性腺激素(hCG)水平呈阳性,初始值为136.9 mIU/mL,随后她顺利产下一名健康婴儿。该病例凸显了辅助生殖技术中处理薄型子宫内膜的挑战。尽管子宫内膜反复变薄,但通过持续努力和量身定制的治疗方案,仍成功实现了活产。该病例强调了个体化治疗策略在克服不孕症治疗中子宫内膜相关挑战方面的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46d9/11378461/d85683c423a9/cureus-0016-00000066363-i01.jpg

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