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目的:探讨体外受精-胚胎移植/卵胞浆内单精子注射(IVF/ICSI)周期失败患者复融周期月经期子宫内膜雌、孕激素受体变化对妊娠率的影响。方法:选取2009年1月～2010年1月IVF/ICSI周期失败患者,复融周期月经来潮24 h内行内膜搔刮术,将刮出物中少量子宫内膜组织送病理检查。按子宫内膜病理分型,分为分泌正常、分泌反应欠佳、增生反应型子宫内膜,比较各组子宫内膜雌、孕激素受体变化及复融周期胚胎种植率、妊娠率及流产率。结果:共获病理报告317例,分泌正常子宫内膜共96例,分泌反应欠佳子宫内膜共143例,增生反应型子宫内膜共78例。增生反应组宫外孕发生率(6.41%)高于分泌反应正常组(0.00%)和分泌反应欠佳组(1.39%),差异有统计学意义(P<0.05)。分泌反应正常组的胚胎着床率(45.79%)和生化妊娠率(62.5%)均高于分泌反应欠佳组(38.08%,50.35%)和增生反应组(34.84%,47.43%),但差异无统计学意义(P>0.05)。分泌反应欠佳组流产率(14.69%)高于分泌反应正常组(7.29%)和增生反应组(8.97%),但差异无统计学意义(P>0.05)。结论:复融周期胚胎移植可以选择分泌良好的周期进行,以提高移植的成功率。
Objective: To investigate the effect of estrogen and progesterone receptor on pregnancy rate during menstruation menstrual cycle in vitro fertilization-embryo transfer / intracytoplasmic sperm injection (IVF / ICSI) cycle failure. Methods: Patients with failed IVF / ICSI cycles between January 2009 and January 2010 were enrolled in this study. Endometrial scraping was performed within 24 hours of the menstrual cycle in the syncretic cycle. A small amount of endometrial tissue was collected for pathological examination. According to pathological classification of endometrium, we divided them into normal secretion, poor secretion reaction, hyperplasia-responsive endometrium, comparison of estrogen and progesterone receptor changes in endometrium, and implantation rate, pregnancy rate and miscarriage of abortion rate. Results: A total of 317 cases of pathological reports were obtained, 96 cases of normal endometrium were secreted, 143 cases of poorly secreted endometrium and 78 cases of proliferative endometrium. The incidence of ectopic pregnancy in hyperplastic reaction group (6.41%) was significantly higher than that in normal secretion group (0.00%) and poorly secreted reaction group (1.39%) (P <0.05). The embryo implantation rate (45.79%) and biochemical pregnancy rate (62.5%) in the normal secretion group were higher than those in the poor secretion group (38.08%, 50.35%) and the proliferative reaction group (34.84%, 47.43% No statistical significance (P> 0.05). The miscarriage rate was higher (14.69%) than the normal secretion (7.29%) and the proliferative response (8.97%), but the difference was not statistically significant (P> 0.05). Conclusion: The cycle of embryo transfer with multiple cycles can be well sected to improve the success rate of transplantation.