Di-san junyi daxue xuebao (Mar 2022)
Effect of accurate assessment for uterine cavity environment on outcome of repeated transplantation failures
Abstract
Objective To evaluate the impact of accurate detection of the uterine cavity environment on the outcome of assisted pregnancy in patients with repeated transplantation failures by detecting the uterine cavity micro-ecology and endometrial receptivity after using the results to guide transplantation. Methods A total of 223 patients with repeated transplantation failure who underwent in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) in the Assisted Reproductive Center of the Sixth Medical Center of Chinese PLA General Hospital from September 2019 to January 2021 were recruited as the research subjects. According to whether they received the uterine cavity micro-ecology and receptivity test, they were divided into experimental group A (n=70), experimental group B (n=80) and control group (n=73). Experimental group A only received uterine cavity micro-ecology test, and experimental group B received uterine cavity micro-ecology and endometrial receptivity test. These 2 groups adjusted the transplantation plan according to the results of tests. The control group had no intervention before the transplantation cycle and received conventional transplantation plan. The basic data of patients, embryo transfer status and pregnancy outcome were compared, and the relationship of uterine cavity microbes combined with endometrial receptivity test and adjustment of transplantation medication regimen with pregnancy outcome was analyzed in the patients with repeated transplantation failures. Results The 16SrRNA sequencing results showed that 58.57% (41/70) of patients with repeated transplantation failure had bacteria detected in the uterine cavity, and 81.43% (57/70) of patients were non-lactobacillus-dominated. With the comparison of basic data, the differences in the patient's age, body mass index (BMI), follicle-stimulating hormone (FSH), endometrial thickness on the day of transformation, and number of embryos transferred were not statistically different in the pairwise comparisons among groups A and B and the control group (P>0.05). In pregnancy outcomes, the embryo implantation rates were 21.57% and 9.09% in the experimental group A and control group, respectively, with that of experimental group A significantly higher than that of the control group (P 0.05). Conclusion Uterine cavity micro-ecology combined with endometrial receptivity results to guide transplantation shows clear significance for patients with repeated transplantation failures. Among them, guiding vaginal pretreatment with Lactobacillus and other drugs based on uterine cavity micro-ecology test results can significantly improve clinical outcome of pregnancy.
Keywords
