| Objective:To investigate the effect of endometrial preparation on pregnancy outcome in patients with unexplained recurrent implantation failure(RIF)during frozen-thawed embryo transfer(FET).Methods:The clinical data of 643 FET cycles of patients diagnosed with unexplained RIF in the Reproductive Center of the First Hospital of Shanxi Medical University from June2019 to June 2021 were retrospectively analyzed.According to the different endometrial preparation schemes,the patients were divided into four groups : natural cycle group(NC group,n = 180),hormone replacement cycle group(HRT group,n = 273),pituitary down regulation + hormone replacement cycle group(Gn RH-a + HRT group,n= 105)and ovulation induction cycle group(OI group,n = 85).The general data,transplantation status and pregnancy outcomes of the four groups were compared.Results:There were no significant differences in general data,number of blastocysts and cleavage stage embryos,blastocyst transfer rate,high-quality embryo rate,progesterone level on the day of transplantation(P),ectopic pregnancy rate,multiple pregnancy rate,live birth rate,abortion rate and early abortion rate among the four groups(P > 0.05).The endometrial thickness,clinical pregnancy rate and embryo implantation rate of the Gn RH-a + HRT group were higher than those of the other three groups(P < 0.05),and the biochemical pregnancy rate was lower than that of the HRT group(P < 0.05).Multivariate regression analysis of clinical pregnancy showed that the use of Gn RH-a down-regulation artificial cycle to prepare the endometrium had a protective effect on patients with unexplained RIF,and the endometrial thickness on the day of transplantation was also positively correlated with pregnancy outcome.Conclusion:In the FET cycle,compared with NC,HRT and OI regimen,Gn RH-a + HRT regimen can better improve the pregnancy outcome of patients with unexplained RIF. |
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