ORİJİNAL ARAŞTIRMALAR
Endometrium Hazırlık Süresinin Dondurulmuş-Çözülmüş Embriyo Transfer Sonuçları Üzerine Etkisi
Effect of Endometrium Preparation Time on Frozen-Thawed Embryo Transfer Results
Received Date : 22 Nov 2022
Accepted Date : 06 Jan 2023
Available Online : 18 Jan 2023
Ahmet Emin MUTLUa, Rabia ATİLLAb
aHüma Kadın Hastalıkları ve Doğum Hastanesi, Doğum ve Kadın Hastalıkları Kliniği, Kayseri, Türkiye
bNiğde Ömer Halisdemir Üniversitesi, Niğde Zübeyde Hanım Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Niğde, Türkiye
Doi: 10.24074/tjrms.2022-94438 - Makale Dili: TR
TJRMS. 2022;6(3):197-202.
ÖZET
Amaç: Bu çalışmanın amacı; in vitro fertilizasyon (IVF) tedavisi gören kadın hastalarda, dondurulmuş-çözülmüş embriyo transferi (DET) sürecinde endometrium
hazırlık süresinin IVF sonuçlarına etkisini değerlendirmektir. Gereç ve Yöntemler: Retrospektif olarak yapılan bu çalışmaya Ocak 2020-Ocak 2022 yılları arasında
infertilite nedeniyle başvuran 18-35 yaş arası, IVF tedavisi görmüş ve bu tedavisinde DET yapılan 225 hasta dahil edilmiştir. Uterin anomali nedeniyle histeroskopi
yapılan, tekrarlayan gebelik kaybı olan, DET sürecinde spontan ovulasyon gelişen, son kontrolde endometriyal kalınlık 7 mm altında kalan, 35 yaş üstü olan, embriyo
biyopisi yapılan ve tedaviye uyum göstermeyen hastalar çalışmaya dahil edilmemiştir. Çalışmaya alınan hastalar endometrium hazırlık süresine göre 2 gruba ayrılmıştır.
Embriyo transfer sürecinde 1. gruptaki 112 hastaya endometrium hazırlığı için 20 günlük tedavi verilmiştir. İkinci gruptaki 113 hastaya ise endometrium hazırlığı
için 16 günlük tedavi uygulanmıştır. IVF tedavisinde DET yapılan her 2 gruptaki hastaların IVF tedavi sonuçları birbiriyle karşılaştırılmıştır. Bulgular:
Dondurulmuş-çözülmüş embriyo transferi yapılan hastaların toplam yaş ortalaması 28 ± 5.12 idi. Gruplar arasında yaş (p=0.69), infertilite süresi (p=0.82), eğitim durumu
(ilköğretim p=0.58, lise p=0.71, üniversite p=0.63) ve vücut kitle indeksi (p=0.37) gibi sosyodemografik özellikler açısından istatistiksel olarak anlamlı bir
farklılık bulunmadı (p>0.05). IVF sonuçları bakımından olgularda endometrium hazırlık süresi karşılaştırıldığında implantasyon (p=0.342), biyokimyasal gebelik
(p=0.417), klinik gebelik (p=0.384), abortus (p=0.557) ve canlı doğum (p=0.489) açısından istatistiksel olarak anlamlı farklılık saptanmadı (p>0.05). Birinci gruptaki
uzun protokol uygulanan hastaların son kontrolünde ölçülen endometriyum kalınlıkları ortalaması 9.1 mm (7.2mm-10.4mm), 2. gruptaki kısa protokol uygulanan
hastaların son kontrolünde ölçülen endometriyum kalınlıkları ortalaması 8.6 mm (7.1mm-9.2mm) olarak tespit edildi (p=0.12). Sonuç: İnfertil hastaların DET
sürecinde endometrial hazırlık süresinin uzaması hem hasta hem de sağlık ekibi üzerinde iş yükü artışına sebep olmaktadır. Endometrial hazırlık süresinin kısalmasının
IVF tedavi başarısını olumsuz etkilemediği tespit edilmiştir. IVF tedavi sürecinde endometrial hazırlık süresinin kısalmasının, hasta takibini kolaylaştırma, aksaklıkları
minimalize etme ve gebelik sonuçlarını olumsuz etkilememesi nedenleriyle uygulamaya alınması önerilir.
Anahtar Kelimeler: Endometrium hazırlık süresi; IVF; dondurulmuş-çözülmüş embriyo transferi; gebelik
ABSTRACT
Objective: The aim of this study; evaluate the effect of endometrial preparation time on IVF outcomes during the frozen-thawed embryo transfer (FET) process in
female patients undergoing in vitro fertilization (IVF) treatment. Material and Methods: In this retrospective study, 225 patients aged 18-35 years who applied for
infertility between January 2020 and January 2022, received IVF treatment and underwent DET in this treatment were included. Patients who underwent hysteroscopy
due to uterine anomaly, had recurrent pregnancy loss, developed spontaneous ovulation during the DET process, had an endometrial thickness below 7 mm at the last
control, were over 35 years old, underwent embryo biopsy and were not compliant with the treatment were not included in the study. The patients included in the study
were divided into 2 groups according to the endometrial preparation time. These patients were divided into 2 groups according to the endometrial preparation time.
During the embryo transfer process, 112 patients in group 1 received 20 days of treatment for endometrial preparation. 113 patients in the second group were treated
for 16 days for endometrial preparation. IVF treatment results of patients in both groups who underwent FET in IVF treatment were compared with each other. Results:
The mean age of patients who underwent frozen-thawed embryo transfer was 28 ± 5.12 years. There were statistically significant sociodemographic characteristics
such as age (p=0.69), duration of infertility (p=0.82), education (primary school p=0.58, high school p=0.71, university p=0.63) and body mass index (p=0.37)
between the groups. no significant difference was found (p>0.05). When the endometrial preparation time was compared in terms of IVF results, there was a statistically
significant difference in terms of implantation (p=0.342), biochemical pregnancy (p=0.417), clinical pregnancy (p=0.384), abortion (p=0.557) and live birth
(p=0.489). not detected (p>0.05). The mean endometrial thicknesses measured at the last control of the patients in the first group who were applied the long protocol
were 9.1 mm (7.2mm-10.4mm), and the mean of the endometrial thicknesses measured at the last control of the patients in the second group who were applied the
short protocol was 8.6 mm (7.1mm-9.2mm) (p= 0.12). Conclusion: The prolongation of the endometrial preparation period in the DET process of infertile patients
causes an increase in workload on both the patient and the healthcare team. It has been determined that the shortening of the endometrial preparation time does not
adversely affect the success of IVF treatment. It is recommended that the shortening of the endometrial preparation time during the IVF treatment process be put into
practice because it facilitates patient follow-up, minimizes disruptions and does not adversely affect pregnancy outcomes.
Keywords: Endometrial preparation time; IVF; frozen-thawed embryo transfer; pregnancy
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