目的 比较来曲唑和氯米芬治疗极严重少精子症的治疗效果。方法 选取2020—2021年在本生殖中心门诊50例极严重少精子症病例,分为2组,A组(来曲唑,研究组n=26)、B组(氯米芬,对照组n=24)。结果 来曲唑和氯米芬治疗后1月、3月,A组精子浓度明显提高,优于B组[(4.5±3.1) vs (2.0±1.3);(8.3±3.5) vs (2.0±1.8),P<0.05]。通过卵胞浆内单精子注射/体外受精胚胎移植治疗,A组妊娠16例(61.5%),B组妊娠11例(45%)。2组治疗后的血清卵泡刺激素、黄体生成素、睾酮升高[(5.9±3.8) vs (20.3±2.6);(3.6±2.8) vs (9.5±5.7);(13.6±10.5) vs (25.3±10.8),P<0.05],A组雌二醇水平降低[(36.8±20.6) vs (7.6±2.5),P<0.05]。结论 来曲唑治疗极严重少精子症有较理想的临床治疗效果,明显优于氯米芬。

Objective To explore and compare the therapeutic effects of letrozole and clomiphene in the treatment of extremely severe oligospermia. Methods A tatal of 50 cases of extremely severe oligosperospermia in the reproductive center from 2020 to 2021 were selected and divided into two groups, group A (letrozole, study group n=26) and B (clomiphene, control group n=24). Results After letrizole and clomiphene treated for 1 and 3 months, sperm concentration in group A was significantly better than group B[(4.5±3.1) vs (2.0±1.3);(8.3±3.5) vs (2.0±1.8),P<0.05]. With ICSI/IVF, 16 cases (61.5%) succeed in encyesis in group A, 11 cases (45%) in group B. Serum follicle stimulating hormone, luteinizing hormone and testosterone levels were significantly increased after treatment [(5.9±3.8) vs (20.3±2.6), (3.6±2.8) vs (9.5±5.7), (13.6±10.5) vs (25.3±10.8), P<0.05]. The level of estradiol in group A decreased [(36.8±20.6) vs (7.6±2.5), P<0.05]. Conclusions Letrozole has ideal clinical treatment effect, which is obviously superior to clommiphene.

目的 探索冻融胚胎移植周期胚胎移植前宫腔灌注胚胎培养上清液对胚胎种植及妊娠结局的影响。方法 纳入我院 2019 年 3 月—2019 年 12 月 共计198个冻 融 胚 胎 移 植 ( frozen-thawed embryo transfer,FET)周期。根据 FET 术前是否予胚胎培养液上清液宫腔灌注操作分成 2 组,灌注组93 个周期,对照组即未灌注组105个周期。灌注组分别于FET术前 4 周和术前 1 天行宫腔灌注胚胎培养上清液,对照组未行胚胎培养上清液宫腔灌注,对比两组患者胚胎着床率、临床妊娠率、流产率。结果 灌注组患者的胚胎着床率高于对照组,差异有统计学意义(P＜0.05)。两组间的临床妊娠率、流产率未见统计学差异(P>0.05)。结论 FET术前宫腔灌注胚胎培养上清液可提高胚胎种植率。

Objective To investigate the potential impact of intrauterine perfusion of embryo culture supernatant before frozen-thawed embryo transfer (FET) on pregnancy outcome. Methods From March to December 2019, a total of 198 FET cycles were enrolled for the present study.Patients were divided into two groups: the study group included 93 cycles, patients in this group received intrauterine perfusion of embryo culture supernatant four weeks and one day before the embryo transfer, respectively; the control group included 105 cycles, and patients in this group did not receive intrauterine perfusion. Rates of implantation, pregnancy, and miscarriage were compared between the two groups. Results The implantation rate in the study group was higher than that in the control group (P<0.05). There were no significant differences in clinical pregnancy rate and abortion rate between the two groups (P>0.05). Conclusion With the performance of intrauterine perfusion of embryo culture supernatant before embryo transfer, the implantation rate may be improved in FET cycles.