Application Of Low Molecular Weight Heparin Calcium In Patients With Repeated Implantation Failure In 79 Cases Pregnancy Outcome Observation

Objective:By observing the clinical pregnancy outcomes of 79 patients with repeated transplantation failures requiring thawed low-molecular-weight heparin calcium and analyzing their live birth rate,implantation rate and clinical pregnancy rate,we investigated whether low-molecular-weight heparin calcium can improve repeated implant failures in patients again.Embryo transfer pregnancy outcomes.Methods:Retrospective analysis of embryo implantation in vitro fertilization and embryo transfer(IVF-ET)in The First Hospital of Shanxi Medical University,Department of Reproduction from October 2015 to March 2017 A total of 163 patients who underwent thaw transplantation were used again.Patients with low-molecular-weight heparin calcium were used as the observation group(79 cases),and low-molecular-weight heparin calcium was not used as a control group(84 cases).Both groups used long-term solutions.Ovulation therapy,which starts on the 3rd day of menstrual menstruation daily,begins to take 1 tablet of Marvelon once a day,and on the 15 th day of Marvelon,uses gonadotropin-releasing hormone(GnRH-a daphyline)1.6-1.8mg to lower the adjustment,when menstruation again Fasting blood tests for FSH,LH,and E2 on the 2-4th day of the orgasm,reaching regulatory down-regulation(E2 <50 pg/ml,LH <5 mIU/mL,FSH <5mIU/ml),and initiation of controlled ovulation induction The drug selection was recombinant human follicle stimulating hormone(FSH Gonafin),urinary folliclestimulating hormone(FSH Lishenbao)and urinary gonadotropin(HMG).The use of vaginal B-ultrasound and peripheral blood hormones to monitor follicular development during the course of medication.When a follicle diameter of 18 mm or 2 follicle diameters of 17 mm was reached,an intramuscular injection of 10,000 IU of human chorionic gonadotropin(hCG)was given at 20:00 that evening.The eggs were taken 36 hours after the injection of HCG.The husband was informed to sequester,after washing,in vitro fertilization culture,embryo transfer after 3 days of oocyte retrieval,transplantation of 2 embryos,and the remaining embryos can be used for cryopreservation.All patients undergoing thawed transplants are required to prepare the endometrium on a manual cycle.2 mg of estradiol valerate tablets(estrogen)are administered twice a day on the third day of the menstrual cycle.Vaginal color Doppler ultrasound is used to monitor the growth of the intima during administration.Membrane thickness adjustment drug dose,when the thickness of the intima reaches 8mm or more,intramuscular injection of progesterone injection,40 mg daily,on the 4th day of progesterone injection fasting blood test progesterone,when the progesterone value reached 15ng/ In the case of ml or more,thawed embryos were transplanted on the fifth day.From the day of transplantation,the observation group used low-molecular-weight heparin calcium4100 IU subcutaneous injection,intramuscular progesterone injection 40 mg,and continued to take the same dose of complementary Jiale.In the control group,only 40 mg of progesterone injection was injected intramuscularly.Blood tests for HCG after 14 days from the date of transplantation are considered positive if they are greater than25mIU/ml,negative if they are less than 25mIU/ml,embryo transfer fails,and low molecular weight heparin calcium and progesterone injections are stopped.If it is positive,continue medication.Transvaginal B-ultrasound was performed on the 30 th day from the day of embryo transfer.If the gestational sac was visible,clinical pregnancy was determined.Low-molecular-weight heparin calcium was stopped.Progesterone injection was continued until 12 weeks of gestation.If no gestational sac was seen,Re-examination of blood HCG was confirmed as biochemical pregnancy,and low-molecular-weight heparin calcium and progesterone injections were stopped.If clinical pregnancy,stop using low-molecular-weight heparin calcium and continue progesterone injection until 10-12 weeks of pregnancy.Collect general information,adverse drug reactions,clinical pregnancy rate,embryo implantation rate,live birth rate,etc.of all patients.In this study,Chi-square test or t test was used to compare and analyze the data of live birth rate,embryo implantation rate,and clinical pregnancy rate between the observation group and the control group.In all statistical analyses,P<0.05 was used.Considered statistically significant.Results:In the low molecular weight heparin group,the clinical pregnancy rate,live delivery rate,planting rate were 35.4% and 31.7% and 20.5%,respectively;in the control group they were 27.4% and 25.0% and 15.8%,respectively.The rates of the two groups were similar(all parameters P > 0.05),although the clinical pregnancy rate,live birth rate and implantation rate in the experimental group were higher than those in the control group.But the data analysis shows that these differences are not statistically significant.Conclusion:Although there is no statistical significance in the study,the living rate,clinical pregnancy rate and implantation rate of low molecular weight heparin group are absolutely different from those of the control group,which may be a significant clinical trend.