碘甘油宫腔灌注联合抗生素治疗对慢性子宫内膜炎患者冻胚移植周期(F-ET)的疗效分析：基于倾向性得分匹配法(PSM)

Efficacy of Intrauterine Infusion of Iodine Glycerol Combined with Antibiotic Therapy on Frozen Embryo Transfer (F-ET) Outcomes in Patients with Chronic Endometritis: A Propensity Score Matching (PSM) Analysis

摘要: 目的：基于倾向性得分匹配法(PSM)，评估碘甘油宫腔灌注联合抗生素治疗对慢性子宫内膜炎(CE)患者冻胚移植周期(F-ET)临床妊娠结局的影响。方法：回顾性分析2022年9月至2024年12月期间在我院生殖中心接受F-ET的229例CE患者的临床资料。其中，122例患者接受碘甘油宫腔灌注联合抗生素治疗，107例患者未接受碘甘油宫腔灌注治疗。采用1:1最邻近匹配法(卡钳值设为0.02)进行PSM匹配，以减少混杂因素影响，最终治疗组与对照组各86例。比较两组治疗后的生化妊娠率、临床妊娠率及早期流产率。结果：PSM匹配前，治疗组(n = 122)与未治疗组(n = 107)在生化妊娠率和临床妊娠率方面均存在显著差异(P < 0.05)。PSM匹配后，治疗组(n = 86)与对照组(n = 86)在生化妊娠率方面差异无统计学意义，但治疗组的临床妊娠率仍显著高于对照组(P = 0.012)，且早期流产率显著低于对照组(P < 0.001)。结论：碘甘油宫腔灌注联合抗生素治疗可显著提高CE患者F-ET周期的临床妊娠率，并降低早期流产率。

Abstract: Objective: To evaluate the impact of intrauterine infusion of iodine glycerol combined with antibiotic therapy on the clinical pregnancy outcomes of frozen embryo transfer (F-ET) in patients with chronic endometritis (CE) using propensity score matching (PSM). Methods: A retrospective analysis was conducted on 229 CE patients who underwent F-ET at our reproductive center between September 2022 and December 2024. Among them, 122 patients received intrauterine infusion of iodine glycerol combined with antibiotics, while 107 patients did not receive iodine glycerol infusion. A 1:1 nearest-neighbor PSM was performed with a caliper value of 0.02 to balance confounding factors, resulting in 86 matched cases in both the treatment and control groups. The biochemical pregnancy rate, clinical pregnancy rate, and early miscarriage rate were compared between the two groups after treatment. Results: Before PSM, significant differences were observed between the treatment group (n = 122) and the untreated group (n = 107) in terms of biochemical pregnancy rate and clinical pregnancy rate (P < 0.05). After PSM, no statistically significant difference was found in the biochemical pregnancy rate between the treatment group (n = 86) and the control group (n = 86). However, the clinical pregnancy rate remained significantly higher in the treatment group than in the control group (P = 0.012), while the early miscarriage rate was significantly lower in the treatment group (P < 0.001). Conclusion: Intrauterine infusion of iodine glycerol combined with antibiotic therapy can significantly improve the clinical pregnancy rate and reduce the early miscarriage rate in CE patients undergoing F-ET.