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目的:探讨反复种植失败(RIF)患者冻融胚胎移植(FET)周期移植时机的选择及对临床结局的影响。方法:选择采用Gn RH-a降调节激素替代方案准备子宫内膜进行FET的RIF患者106例,随机分为A组(常规法)53个周期,即孕酮作用内膜3 d后移植第3日胚胎;B组(改良法)53个周期,即延迟内膜扳机和黄体支持用药,比较组间血清性激素水平、临床妊娠率、早期流产率等相关指标。结果:患者的基本情况组间具有可比性(P>0.05);移植日雌二醇(E_2)、孕酮(P)、E_2/P、临床妊娠率组间均有统计学差异(P<0.05);移植前1日血清P水平组间差异有统计学意义(P<0.05)。结论:对于RIF患者,在降调节联合激素替代-FET周期中,延长雌、孕激素用药时间可刺激内膜达到理想状态,进而获得满意的妊娠结局。
Objective: To explore the timing of frozen-thawed embryo transfer (FET) cycles in patients with repeated implantation failure (RIF) and the impact on clinical outcomes. Methods: One hundred and sixty-six patients with RIF who were treated with Gn RH-a down-regulation hormone replacement program were randomly divided into group A (n = 53), group A Japanese embryos; group B (modified method) 53 cycles, namely delayed intimal triggers and luteal support medication, compared serum levels of serum hormones, clinical pregnancy rates, early abortion rates and other related indicators. Results: The basic situation of the patients was comparable between the two groups (P> 0.05). There was significant difference between the two groups on the day of transplantation (E2, P, E_2 / P, clinical pregnancy rate) ); The level of serum P on the 1st day before transplantation showed significant difference (P <0.05). CONCLUSIONS: In patients with RIF, prolonged administration of estrogen and progesterone can stimulate the intima to achieve an ideal condition during the down-regulation combined with hormone replacement-FET cycle, thus achieving satisfactory pregnancy outcomes.