The Effect Comparison Of Low Molecular Weight Heparin And Growth Hormone On Patients With Repeated Implantation Failures

Objectives To investigate the effects of low molecular weight heparin(LMWH)and growth hormone(GH)on the process and the outcome of pregnancy after repeated in vitro fertilization and embryo transfer(RIF).Methods The study was performed on patients with repeated implantation failures from June 2015 to February 2017 in reproductive medicine center of Tangshan Maternal and Child Health Hospital,the patients all went through IVF/ICSI-ET multiple times(? 3cycles,including thawing cycles),and began a new cycle.124 cycles of infertility patients were studied,the method is prospective.Randomly matched patients were divided into conventional group of 42 cycles,LMWH group of 41 cycles,GH group of 41 cycles.Compare the number of retrieved oocytes,MII oocytes,high quality embryos,the rate of high quality embryos.The endometrial thickness and endometrial A/B type ratio on the day of HCG injection were aslo analyzed.Biochemical pregnancy rate,embryo implantation rate,clinical pregnancy rate were aslo compared between three groups.Two age groups cut by 35 year old were stratified in three groups and their pregnancy outcomes were analyzed,also cut the three groups into with/without prethrombotic state and analyzed thier pregnancy outcomes.Thus to explore LMWH's and GH's application value in patients with RIF and compare the different possible mechanism between two durgs.Results 1.There were no significant differences in the age,duration of infertility,BMI,AFC,the lever of basal FSH and basal E2 lever and prethrombotic state rates between the three groups(P>0.05).No statistical difference was found in the dosage and duration of gonadotrophin(Gn)and the lever of E2 during the day of HCG injection(P>0.05).There was no significant difference in the number of retrieved oocytes,MII oocytes,high quality embryos,the rate of high quality embryo in the three groups(P>0.05).There was no significant difference in the values of TT,APTT,PT,FIB and D-Di between the three groups(P>0.05).2.No statistical difference was found in the endometrial thickness and A/B type of endometrial ratio between the three groups(P>0.05).3.There were no significant differences in embryo implantation rate and clinical pregnancy rate between the three groups(P>0.05),the biochemical pregnancy rate of LMWH group was significantly higher than that of conventional group(P<0.017),no statistical difference was found in biochemical pregnancy rate of LMWH group and GH group(P>0.017),no statistical difference was found in biochemical pregnancy rate of conventional group and GH group(P>0.017).4.When the <35 year old members of three groups was choosed,there was no significant difference in the rate of embryo implantation and clinical pregnancy between the three groups(P>0.05),meanwile,When choose the ?35 year old members of three groups,the rate of embryo implantation and clinical pregnancy are higher in LMWH group and GH group,but not reach statistical difference(P>0.05).5.When choose the members without prethrombotic state of three groups,the three groups of patients' s embryo implantation rate,clinical pregnancy rate was no significant difference(P>0.05).When choose the members with prethrombotic state of three groups,there was no significant difference in the implantation rate between the three groups(P>0.05).But the clinical pregnancy rate of LMWH group was significantly higher than that of the conventional group(P<0.017),no statistical difference was found in clinical pregnancy rate of LMWH group and GH group(P>0.017),no statistical difference was found in clinical pregnancy rate of conventional group and GH group(P>0.017).Conclusions 1 Low molecular weight heparin can can have more obvious benefits for patients who are in the state of hypercoagulable tend,LMWH can improve their clinical pregnancy significantly.The application of LMWH are in high safety,LMWH may be considered as an adjuvant durg for RIF patients with prethrombotic state.2 Growth hormone may not be beneficial for RIF patients without exact cause.3 The causes of repeated planting failure are complex,it is necesary to strengthen the screening the etiology of RIF,and the choice of individual medication should also be emphasized at the same time.