{"id":122,"title":"Growth hormone intrauterine perfusion improves pregnancy outcomes in frozen-thawed embryo transfer cycles and identifies effect modifiers: a propensity score-matched single-center retrospective cohort study","title_zh":"宫腔灌注生长激素改善冻融胚胎移植妊娠结局并识别效应修饰因素：一项倾向性评分匹配的单中心回顾性队列研究","url":"https://pubmed.ncbi.nlm.nih.gov/42968038","doi":"10.1186/s12884-026-09713-x","pmid":"42968038","journal":"BMC Pregnancy Childbirth","kind":"paper","lang":"en","published_at":"2026-08-05T00:00:00+00:00","fetched_at":"2026-11-08T03:43:53+00:00","authors":["Zhang Q","Li S","Zhao Z","Yu T","Sun K","Wang B","Yu Y"],"primary_topic":"art-clinical","topics":[{"slug":"art-clinical","score":10.0,"hits":["assisted reproductive","blastocyst transfer","clinical pregnancy","embryo transfer","fet","live birth","live birth rate"]},{"slug":"early-pregnancy","score":5.0,"hits":["pregnancy outcomes","spontaneous abortion"]},{"slug":"endometrium","score":3.0,"hits":["endometrial","endometrial receptivity","thin endometrium"]},{"slug":"repro-endo","score":2.0,"hits":["amh","diminished ovarian reserve"]},{"slug":"contraception-health","score":2.0,"hits":["abortion","birth rate"]},{"slug":"early-embryo","score":1.0,"hits":["blastocyst"]},{"slug":"oocyte","score":1.0,"hits":["ovarian reserve"]},{"slug":"repro-tox","score":1.0,"hits":["bmi"]}],"topic_score":10.0,"preference_score":5.0,"preference_labels":["可转化到 ART 实验室的发现"],"llm_score":72.0,"final_score":77.0,"score_dims":{"novelty":65,"rigor":72,"impact":68,"relevance":92,"translation":78},"recommend_reason":"样本量较大且采用倾向性评分匹配、交互与中介分析，明确给出可能获益的亚组（高龄前、超重/肥胖、DOR、薄内膜、囊胚移植），对FET内膜准备阶段的临床决策有直接参考价值；但为单中心回顾性研究，存在适应证混杂，机制结论仅为相关性。","keywords":["宫腔灌注生长激素","冻融胚胎移植","子宫内膜容受性","倾向性评分匹配","活产率","效应修饰因素"],"selected":1,"story_id":469,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-art","source_name":"PubMed · 辅助生殖临床","source_tier":1,"mention_count":3,"has_interpretation":false,"journal_key":"bmc-preg","journal_tier":"standard","journal_if":2.8,"is_mock":false,"summary_zh":"为探讨宫腔灌注生长激素（GH）对冻融胚胎移植（FET）结局的关联及其获益人群，本研究纳入2023年1月至2024年12月单中心4060个FET周期，按是否接受GH宫腔灌注分组，经1:1倾向性评分匹配平衡13项协变量后纳入900个周期，采用广义估计方程、交互检验、亚组分析、探索性因子分析与Bootstrap中介分析并做敏感性分析。结果显示GH灌注组临床妊娠率与活产率显著升高、自然流产率降低，且GH灌注与临床妊娠和活产的较高 odds 独立相关；<35岁、BMI≥24 kg/m²、AMH≤1.1 ng/ml、薄型子宫内膜及囊胚移植者获益更明显，子宫内膜厚度-血流因素起部分中介作用。结论提示GH宫腔灌注与更优FET结局相关，但单中心回顾性设计及确切机制仍需进一步验证。","summary":"BACKGROUND: Pregnancy outcomes in frozen-thawed embryo transfer (FET) cycles are still unsatisfactory in assisted reproductive technology, and poor endometrial receptivity is a core barrier. The efficacy, effect modifiers and mechanisms of growth hormone (GH) intrauterine perfusion for FET remain unclear. This study aimed to investigate the association of GH intrauterine perfusion with pregnancy outcomes, identify key beneficiaries and preliminarily explore the potential clinical pathway for clinical precise application. METHODS: A single-center retrospective cohort study was performed with 4060 FET cycles from January 2023 to December 2024. Cycles were divided into GH perfusion group and control group. One-to-one propensity score matching was used to balance 13 covariates, and 900 cycles were included. Generalized estimating equations, interaction tests, subgroup analyses, exploratory factor analysis and Bootstrap mediation analysis were adopted, and sensitivity analysis was conducted to verify result stability. RESULTS: Baseline covariates were well balanced after matching. The GH perfusion group had significantly higher clinical pregnancy rate and live birth rate, and lower spontaneous abortion rate. GH perfusion was independently associated with higher odds of clinical pregnancy and live birth. Patients younger than 35 years, with BMI ≥ 24 kg/m², AMH ≤ 1.1 ng/ml, thin endometrium and blastocyst transfer benefited more. Endometrial thickness-blood flow factor played a partial mediating role, and sensitivity analysis supported the robustness of results. CONCLUSIONS: GH intrauterine perfusion was associated with better pregnancy outcomes among FET patients in this cohort. Overweight/obese patients, those with diminished ovarian reserve or thin endometrium, and blastocyst transfer recipients appeared to gain greater relative benefit. Correlation analysis suggested this intervention might be associated with higher live birth rates through changes in endometrial thickness and blood flow profiles, while full underlying mechanisms require further investigation.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}