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·论著·

抗生素对首次种植失败合并慢性子宫内膜炎女性

再次冻融胚胎移植结局的影响研究

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魏珑珑，张翠莲 * 查看原文

【摘要】 背景 慢性子宫内膜炎（CE）是指子宫内膜的慢性炎症。近年研究发现，CE 与不孕症、复发性流产
及反复种植失败密切相关，然而目前尚未有关于首次种植失败患者中 CE 的发生情况及抗生素治疗后该类患者再次助
孕结局的研究。目的 探讨在体外受精 - 胚胎移植（IVF-ET）助孕过程中首次种植失败女性 CE 的发生率及抗生素治
疗对其下一次冻融胚胎移植结局的影响。方法 收集 2017 年 5 月至 2021 年 5 月于河南省人民医院行 IVF-ET 助孕后
首次种植失败的 381 例患者的临床资料。宫腔镜及内膜组织病理结果排除 CE 的患者归为非 CE 组（n=333），根据抗
生素治疗后 CE 患者转归情况将 CE 患者分为 CE 转阴组（n=37）及 CE 持续阳性组（n=11），比较非 CE 组、CE 转阴组、
CE 持续阳性组三组人群临床资料和再次助孕的妊娠结局。结果 三组年龄、BMI、移植日内膜厚度、不孕年限、移植
胚胎数、不孕类型等比较，差异无统计学意义（P>0.05）。三组间胚胎种植率、临床妊娠率比较，差异有统计学意义
（P<0.05）；其中非 CE 组、CE 转阴组胚胎种植率、临床妊娠率均高于 CE 持续阳性组（P<0.05）。三组早期流产率比较，
差异无统计学意义（P>0.05）。结论 确诊为 CE 的患者应采用规范的抗生素治疗，未治愈的 CE 将对再次冻融胚胎移
植的结局产生不良影响；建议首次种植失败患者积极进行宫腔镜检查及病理学检查寻找可能病因。
【关键词】 慢性子宫内膜炎；胚胎移植；种植失败；宫腔镜检查；抗生素；助孕结局
【中图分类号】 R 711.32 R 321.3 【文献标识码】 A DOI：10.12114/j.issn.1007-9572.2022.0080
魏珑珑，张翠莲 . 抗生素对首次种植失败合并慢性子宫内膜炎女性再次冻融胚胎移植结局的影响研究［J］. 中国
全科医学，2022，25（21）：2605-2609. ［www.chinagp.net］
WEI L L，ZHANG C L. Effect of antibiotic therapy on the outcome of frozen-thawed embryo retransfer following failed first
implantation in women with chronic endometritis［J］. Chinese General Practice，2022，25（21）：2605-2609.

Effect of Antibiotic Therapy on the Outcome of Frozen-thawed Embryo Retransfer Following Failed First Implantation
in Women with Chronic Endometritis WEI Longlong，ZHANG Cuilian *
Reproductive Center，Henan Provincial People's Hospital，Zhengzhou 454000，China
*
Corresponding author：ZHANG Cuilian，Chief physician，Doctoral supervisor；E-mail：1257672564@qq.com
【Abstract】 Background Chronic endometritis（CE） refers to chronic inflammatory condition of the endometrium.
Recent studies have found that CE is closely associated with infertility，recurrent miscarriage，and recurrent implantation failure.
However，there are no studies on CE prevalence in patients with first implantation failure and the outcome of re-pregnancy by
assisted reproductive technology in these patients after antibiotic treatment. Objective To investigate CE prevalence in women
who used in vitro fertilization & embryo transfer（IVF-ET） to assist in achieving a pregnancy but had failed first implantation
and the impact of antibiotic treatment on the outcome of the next frozen-thawed embryo transfer in this group. Methods Women
（n=381） who received IVF-ET to assist in achieving a pregnancy but had failed first implantation were selected from Henan
Provincial People's Hospital from May 2017 to May 2021. 333 patients without CE were according to hysteroscopic and endometrial
histopathological findings. 37 of CE patients were found with reversed（cured） clinical condition，but the other 11 still with
unreversed（uncured） condition who were received antibiotic treatment . Clinical data and the outcome of the second assisted
conception were compared between cured and uncured CE patients，as well as non-CE patients. Results Cured and uncured
CE patients and non-CE patients had no statistical differences in mean age，BMI，endometrial thickness on the day of embryo
transfer，years of infertility，and number of embryos transferred，as well as the distribution of infertility type（P>0.05）. But
they had statistical differences in success rates of embryo retransfer and pregnancy（P<0.05）. Cured CE patients and non-CE

基金项目：2020 年度河南省医学科技攻关计划省部共建重大项目（SBGJ202001002）
454000 河南省郑州市，河南省人民医院生殖医学中心
*
通信作者：张翠莲，主任医师，博士研究生导师；E-mail：1257672564@qq.com
本文数字出版日期：2022-05-19