摘要目的 探讨西地那非对冻融胚胎移植周期(FET)中子宫内膜血流不良患者子宫内膜血流及妊娠率的影响。方法 对本院2017年1—12月行冻融胚胎移植、超声提示子宫内膜血流不良且年龄<40岁的269例患者共288个冻融移植周期进行回顾研究,其中应用西地那非188个周期(西地那非组),对照组100个周期,测量子宫内膜厚度,观察子宫内膜血流及妊娠结局。结果 288个FET周期中有246个周期于移植前复查血流情况,其中西地那非组共168个周期,其中148个周期(88.1%)子宫内膜血流有所改善,20个周期(12.9%)无改善;对照组共78个周期,其中60个周期(76.9%)子宫内膜血流有所改善,18个周期(23.1%)无改善;两组间差异有统计学意义。西地那非组和对照组之间临床妊娠率(47.0% vs 37.2%)、流产率(25.5% vs 18.6%)和活产率(31.0% vs 29.8%)差异均无统计学意义。结论 西地那非能改善部分子宫内膜血流不良患者的血流状态,但对提高胚胎着床率及临床妊娠率的有效性尚缺乏明确的证据支持。
Abstract：Objective To investigate the effect of sildenafil on endometrial blood flow and pregnancy rate in patients with poor endometrial blood flow during frozen-thawed embryo transfer (FET). Methods From January 2017 to December 2017, 288 FET cycles from 269 patients aged <40 years old and with poor endometrial blood flow were studied. The endometrial thickness, blood flow, and pregnancy outcomes were recorded in 188 cycles of sildenafil group and 100 cycles of the control group. Results 246 out of 288 cycles were reexamined endometrial blood flow before transplantation. There were 168 cycles in sildenafil group, and 148 cycles (88.1%) showed improvement in endometrial blood flow, 20 cycles (12.9%) showed no improvement. There are 78 cycles in control group, and 60 cycles (76.9%) showed improvement in endometrial blood flow, 18 cycles (23.1%) showed no improvement. And the differences between sildenafil group and control group were statistically significant. There was no significant difference in clinical pregnancy rate (47.0% vs 37.2%), abortion rate (25.5% vs 18.6%), or live birth rate (31.0% vs 29.8%) between the two groups. Conclusion Sildenafil has partial improvement in the endometrial blood flow, and there is no clear evidence to support the improvement in embryo implantation rate and clinical pregnancy rate.
张佳佳, 甄秀梅, 李蓉, 王丽娜, 王丽颖. 冻融胚胎移植周期中西地那非对子宫内膜血流不良者妊娠结局的影响[J]. 中国生育健康杂志, 2022, 33(2): 114-118.
ZHANG Jiajia, ZHEN Xiumei, LI Rong, WANG Lina, WANG Liying. Effect of sildenafil on pregnancy outcomeof frozen-thawed embryo transfer cycles with poor endometrial blood flow. Chinese Journal of Reproductive Health, 2022, 33(2): 114-118.
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