子宫内膜容受性检测技术在反复种植失败患者冻融胚胎移植中的应用价值及其临床妊娠的影响因素分析

摘要 目的：探讨子宫内膜容受性检测（ERT）技术在反复种植失败患者冻融胚胎移植（FET）中的应用价值，并分析其临床妊娠的影响因素。方法：回顾性分析2019年10月~2022年4月期间海南省妇女儿童医学中心收治的150例反复种植失败患者的临床资料，根据是否接受ERT技术分为ERT组（n=78，接受ERT技术）和无ERT组（n=72，未接受ERT技术）。按照反复种植失败患者是否临床妊娠分为临床妊娠组和未临床妊娠组。采用单因素和多因素Logistic回归模型分析临床妊娠的影响因素。结果：两组异位妊娠率组间对比未见统计学差异（P>0.05）。ERT组临床妊娠率、活产率高于无ERT组，移植日内膜厚度大于无ERT组，移植胚胎数少于无ERT组，流产率低于无ERT组（P<0.05）。所有患者按照是否临床妊娠分为临床妊娠组（n=85）和未临床妊娠组（n=65）。单因素分析结果显示：临床妊娠与年龄、移植胚胎类别、移植胚胎数量、总周期数、FSH、子宫内膜厚度、子宫内膜类型有关（P<0.05），而与体质量指数（BMI）、不孕年限、不孕类型、胚胎冷冻保存时间无关（P>0.05）。多因素Logistic回归分析结果显示：年龄偏大、FSH偏高是临床妊娠的危险因素，而移植胚胎类别为囊胚、移植胚胎数量偏多是临床妊娠的保护因素（P<0.05）。结论：ERT技术用于反复种植失败患者FET中，可有效改善患者的临床妊娠。年龄、FSH、移植胚胎类别、移植胚胎数量是临床妊娠的影响因素。

Application Value of Endometrial Receptivity Test in Frozen-Thawed Embryo Transfer in Patients with Repeated Implantation Failure and its Influencing Factors of Clinical Pregnancy

ABSTRACT Objective: To explore the application value of endometrial receptivity test (ERT) in frozen-thawed embryo transfer (FET) in patients with repeated implantation failure, and to analyze the influencing factors of clinical pregnancy. Methods: The clinical data of 150 patients with repeated implantation failure who were admitted to Hainan Women and Children''s Medical Center from October 2019 to April 2022 were retrospectively analyzed, patients were divided into ERT group (n=78, received ERT technology) and non-ERT group (n=72, did not receive ERT technology) according to whether they received ERT technology. Patients were divided into clinical pregnancy group and non-clinical pregnancy group according to the clinical pregnancy of patients with repeated implantation failure. The influencing factors of clinical pregnancy were analyzed by univariate and multivariate Logistic regression models. Results: There was no significant difference in ectopic pregnancy rate between two groups(P>0.05). The clinical pregnancy rate and live birth rate in ERT group were higher than those in non-ERT group, the endometrial thickness on the day of transplantation was greater than that in non-ERT group, the number of transplanted embryos was less than that in non-ERT group, and the abortion rate was lower than that in non-ERT group (P<0.05). All patients were divided into clinical pregnancy group (n=85) and non-clinical pregnancy group (n=65). The results of univariate analysis showed that, clinical pregnancy was related to age, type of transplanted embryos, number of transplanted embryos, total number of cycles, FSH, endometrial thickness and endometrial type(P<0.05), and it was not related to body mass index (BMI), infertility years, infertility type, and Embryos were cryopreserved for the storage time(P>0.05). Multivariate Logistic regression analysis showed that, older age and higher FSH were risk factors for clinical pregnancy, while type of transplanted embryos is blastocyst and more transplanted embryos were protective factors for clinical pregnancy(P<0.05). Conclusion: ERT technology can effectively improve the clinical pregnancy of patients with repeated implantation failure in FET. Age, FSH, type of transplanted embryos and number of transplanted embryos are the influencing factors of clinical pregnancy.