标题：来曲唑、FSH促排卵方案及HRT方案在PCOS患者冻融单囊胚胎移植内膜准备中的应用

      作者：何雪梅，李萍    厦门大学附属妇女儿童医院(厦门市妇幼保健院)生殖医学科，福建 厦门 361000

      卷次： 2024年35卷14期

      【摘要】 目的 探讨来曲唑、卵泡刺激素(FSH)促排卵方案及激素替代治疗(HRT)方案在多囊卵巢综合征(PCOS)患者冻融单囊胚胎移植内膜准备中的应用效果。方法 选择2021年1月至2022年12月厦门市妇幼保健院206例接受冻融单囊胚移植的PCOS患者作为研究对象，按随机数表法分为A组69例、B组69例和C组68例。三组患者分别采用不同内膜准备方案，其中A组使用来曲唑方案，B组使用FSH促排卵方案，C组使用HRT方案。比较三组患者的治疗情况、妊娠情况及母婴结局。结果 三组患者的胚胎移植个数比较差异无统计学意义(P>0.05)；三组患者的生化妊娠、临床妊娠、异位妊娠比较差异均无统计学意义(P>0.05)，而A组患者的持续妊娠、活产率分别为60.87%、57.97%，B组分别为59.42%、55.07%，均高于C组的41.18%、36.76%，差异均有统计学意义(P<0.05)，但A组和B组患者的持续妊娠、活产率比较差异无统计学意义(P>0.05)；三组患者的妊娠期糖尿病、妊娠期高血压、前置胎盘、剖宫产、产后出血发生率及分娩孕周、新生儿体质量和早产比较差异均无统计学意义(P>0.05)。结论 与HRT方案相比，使用来曲唑、FSH促排卵方案进行内膜准备有助于提高PCOS患者冻融单囊胚胎移植后的持续妊娠率及活产率。
      【关键词】 多囊卵巢综合征；胚胎移植；来曲唑；卵泡刺激素；激素替代治疗；母婴结局
      【中图分类号】 R711.75 【文献标识码】 A 【文章编号】 1003—6350（2024）14—2017—04

Application of letrozole, FSH ovulation induction regimen, and hormone replacement therapy in endometrialpreparation for single frozen-thawed embryo transfer in patients with polycystic ovary syndrome.
HE Xue-mei, LIPing. Department of Reproductive Medicine, Xiamen Women and Children's Hospital (Xiamen Maternal and Child HealthHospital), Xiamen 361000, Fujian, CHINA
【Abstract】 Objective To investigate the effect of letrozole, follicle-stimulating hormone (FSH) ovulation in-duction regimen, and hormone replacement therapy (HRT) regimen on endometrial preparation for single frozen-thawedembryo transfer in patients with polycystic ovary syndrome (PCOS).Methods A total of 206 patients who received sin-gle frozen-thawed embryo transfer in Xiamen Maternal and Child Health Hospital from January 2021 to December 2022were selected and divided into group A (69 cases), group B (69 cases), and group C (68 cases) according to random num-ber table, which were treated with letrozole, FSH ovulation induction regimen, and HRT for endometrial preparation, re-spectively. The treatment status, pregnancy status, and maternal and infant outcomes were compared among the threegroups. Results There was no significant difference in the number of embryo transfer among the three groups (P>0.05); there was no statistically significant differences in biochemical pregnancy, clinical pregnancy, and ectopic pregnan-cy among the three groups (P>0.05); the rates of continuous pregnancy and live birth were 60.87% and 57.97% in groupA and 59.42% and 55.07% in group B, which were significantly higher than 41.18% and 36.76% in group C (P<0.05).There was no statistically significant differences in the rates of continuous pregnancy and live birth between group A andgroup B (P>0.05). There was no significant difference in the incidence of gestational diabetes mellitus, gestational hyper-tension, placenta previa, cesarean section, postpartum hemorrhage, gestational week, neonatal weight, and premature de-livery among the three groups (P>0.05). Conclusion Compared with HRT regimen, endometrial preparation using le-trozole and FSH ovulation induction regimen for ovulation induction can improve the continuous pregnancy rate and livebirth rate of PCOS patients after single frozen-thawed embryo transfer.
      【Key words】 Polycystic ovary syndrome; Embryo transfer; Letrozole; Follicle stimulating hormone; Hormone re-placement therapy; Maternal and infant outcome