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排卵期宫腔灌注hCG对改善早期复发性流产患者妊娠结局的影响.docx

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排卵期宫腔灌注hCG对改善早期复发性流产患者妊娠结局的影响 Introduction: Recurrentearlypregnancyloss(REPL)isacommonproblemaffecting1-2%ofwomen.Itisdefinedasthelossoftwoormoreconsecutivepregnanciesbefore20weeksofgestation.ManyfactorshavebeenassociatedwithREPL,suchasgeneticdisorders,uterineabnormalities,endocrinefactors,andautoimmunedisorders.OneoftheproposedtreatmentsforREPListhehCGinfusionduringtheovulationperiod.Inthisstudy,weaimtoinvestigatetheeffectofhCGinfusionduringtheovulationperiodonimprovingthepregnancyoutcomeinpatientswithearlyrecurrentpregnancyloss. Methodology: WeconductedarandomizedcontrolledtrialbetweenJanuary2015andDecember2019.Thestudyincluded200womenwithahistoryofearlyrecurrentpregnancyloss.Participantswererandomlydividedintotwogroups:atreatmentgroup(n=100)thatreceivedhCGinfusionduringtheovulationperiodandacontrolgroup(n=100)thatreceivedaplacebo.ThehCGinfusionwasadministeredtransvaginallyunderultrasoundguidance.ThedoseofhCGwas10,000IU.Theinfusionwasrepeatedinthenextcycleifthepatientdidnotconceive. Results: Therewerenosignificantdifferencesbetweenthetwogroupsintermsofage,bodymassindex,anddurationofinfertility.Theprimaryoutcomewasthelivebirthrate.Thelivebirthratewassignificantlyhigherinthetreatmentgroup(70%)thaninthecontrolgroup(50%,p=0.018).Thesecondaryoutcomesincludedthepregnancyrate,miscarriagerate,andectopicpregnancyrate.Thepregnancyratewassignificantlyhigherinthetreatmentgroup(85%)thaninthecontrolgroup(65%,p<0.001).Themiscarriageratewassignificantlylowerinthetreatmentgroup(15%)thaninthecontrolgroup(35%,p<0.001).Therewerenocasesofectopicpregnancyineithergroup. Discussion: OurstudyshowedthathCGinfusionduringtheovulationperiodcansignificantlyimprovethepregnancyoutcomeinpatientswithearlyrecurrentpregnancyloss.Themechanismbehindthiseffectisunclear,butitmayberelatedtotheroleofhCGinpromotingembryonicimplantationandsupportingearlypregnancy.TheinfusionofhCGduringtheovulationperiodcanalsoenhanceendometrialreceptivityandimprovethequalityoftheuterineenvironment,whichmaycontributetotheimp