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目的探讨自体外周血单个核细胞(PBMCs)宫腔内灌注治疗对反复种植失败(RIF)患者胚胎种植率和临床妊娠率的影响。方法按随机数字表法将纳入的39例拟行冷冻胚胎移植的RIF患者随机分为治疗组(20例)和对照组(19例),治疗组在移植前3 d抽取外周血20 ml,应用淋巴细胞分离液分离PBMC后行宫腔灌注。对照组移植前未行自体PBMC宫腔灌注。结果两组患者年龄、血清卵泡刺激激素(FSH)、取卵周期数、移植周期数、移植胚胎数和单周期移植优质胚胎数均无统计学差异(P>0.05)。两组胚胎种植率(22.8%vs.6.4%)和临床妊娠率(50.0%vs.17.6%)比较,治疗组均显著高于对照组(P<0.05)。两组单周期活婴出生率(45.0%vs.17.6%)比较无统计学差异(P>0.05)。结论自体PBMC宫腔内灌注治疗可以提高RIF患者胚胎种植率和临床妊娠率,故可作为RIF患者胚胎移植前提供可选择的处理方案。
Objective To investigate the effects of intrauterine perfusion of autologous peripheral blood mononuclear cells (PBMCs) on implantation rate and clinical pregnancy rate in patients with repeated implantation failure (RIF). Methods Totally 39 RIF patients enrolled in this study were randomly divided into treatment group (n = 20) and control group (n = 19) according to random number table method. In the treatment group, 20 ml of peripheral blood was drawn 3 days before transplantation. Intrauterine perfusion was performed after PBMCs were isolated from lymphocytes. The control group had no autologous PBMC uterine perfusion before transplantation. Results There were no significant differences in age, serum FSH, number of ovulation cycles, number of transplantation cycles, numbers of embryos transferred and number of high quality embryos transplanted in one-cycle (P> 0.05). The two groups of embryo implantation rate (22.8% vs.6.4%) and clinical pregnancy rate (50.0% vs.17.6%), the treatment group were significantly higher than the control group (P <0.05). The single-cycle live birth rate (45.0% vs.17.6%) was no significant difference between two groups (P> 0.05). Conclusion Intrauterine perfusion of autologous PBMC can improve embryo implantation rate and clinical pregnancy rate in patients with RIF. Therefore, it can be used as an alternative treatment for RIF patients before embryo transfer.