摘要
目的探讨他莫昔芬(tamoxifen)方案应用于以往自然周期和激素替代治疗反复出现子宫内膜薄的患者行冻融胚胎移植(FET)时子宫内膜准备的临床效果。方法 2011年11月至2014年4月南方医科大学南方医院妇产科生殖医学中心,回顾性分析61例既往因自然周期和激素替代治疗准备冷冻周期子宫内膜,显示子宫内膜薄而取消移植或者移植后未妊娠患者使用他莫昔芬治疗,观察子宫内膜厚度、性激素水平以及FET后的妊娠结局。结果他莫昔芬周期和既往激素替代治疗周期相比,前者的子宫内膜厚度[(8.8±1.8)mm、(6.5±0.3)mm]和血清雌二醇(E2)水平[(2091.2±1020.5)pmol/L、(969.6±474.2)pmol/L]明显较高,且差异具有统计学意义(P<0.05);子宫内膜准备天数明显减少[(13.2±2.9)d、(23.1±4.9)d],差异有统计学意义(P<0.05)。他莫昔芬周期的临床妊娠率、早期流产率、胚胎种植率、畸形率分别为44.3%(27/61)、7.4%(2/27)、24.2%(32/132)、0(0/17)。结论对于子宫内膜薄的患者,在冻融胚胎移植周期使用他莫昔芬准备子宫内膜方法简单可行,而且子宫内膜准备时间较短、子宫内膜厚度显著提高,并可获得较满意的妊娠结局。
Objective To explore the effect of tamoxifen（TAM） on endometrium preparation in patients with thin endometrium for frozen-thawed embryo transfer （FET）.Methods Retrospectively analyze 61 patients visiting the Center for Reproductive Medicine, Department of Gynecology and Obstetrics,Nanfang Hospital, affiliated to Southern Medical University for IVF/ICSI from November 2011 to April 2014, who canceled embryo transfer （ET） or failed to have conception after FET due to thin endometrium in natural cycle or hormone replacement therapy cycle. In these patients TAM was used to prepare endometrium for FET. The endometrial thickness, levels of hormone, and clinical outcomes were analyzed.Results The endometrial thickness and serum E2 level in TAM cycles were significantly higher compared with those in hormone replacement therapy cycle [（8.8± 1.8） mm vs. （6.5±0.3） mm,P〈0.05; （2091.2± 1020.5 ） pmol/L vs. （969.6±474.2）pmol/L,P〈O.05]. Days to prepare the endometrium was shorter （13.2 ±2.9 days vs. 23.1 ± 4.9 days）, and the difference was statistically significant. The clinical pregnancy rate, early miscarriage rate, implantation rate, and deformity rate in TAM cycle were 44.3% （27/61）, 7.4% （2/27）, 24.2% （32/132）, and 0% （0/17）, respectively. Conclusion It＇s simple and feasible to use tamoxifen in patients with thin endometrium while undergoing frozen- thawed embryo transfer,which has short duration of endometrial preparation, significantly improves the endometrial thickness, and results in satisfactory pregnancy rate.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2015年第8期736-740,共5页
Chinese Journal of Practical Gynecology and Obstetrics
基金
广州市科技计划项目重点项目(11C22120737)
国家自然科学基金(81170574)
南方医科大学南方医院高层次匹配课题基金(G201206)
