目的 比较他莫昔芬（TAM）、TAM 联合富血小板血浆（PRP）宫腔灌注及激素替代治疗（HRT）联合 PRP 宫腔灌注在薄型子宫内膜患者冻融胚胎移植（FET）中的临床妊娠结局。 方法 回顾性分析 2023年1月至2025年4月321例于广东省生殖医院生殖医学中心行FET的薄型子宫内膜（既往周期内膜厚度≤ 7 mm）患者的临床资料，根据治疗方案分为3组：TAM组（A组，n = 98）、TAM + PRP组（B组，n = 91）、HRT + PRP组（C组，n = 132）。比较3组患者的一般资料、治疗前后转化日子宫内膜厚度、临床妊娠结局及子宫内膜准备治疗费用。 结果 3组患者年龄、不孕年限、不孕类型、抗苗勒管激素（AMH）水平、基础卵泡刺激素（FSH）均差异无统计学意义（P > 0.05）。治疗后3组患者子宫内膜转化日子宫内膜厚度及增加幅度差异无统计学意义（P > 0.05）。A组、B组和C组的临床妊娠率分别为56.1%、51.6%、43.2%，差异有统计学意义（P = 0.011）、胚胎种植率分别为43.6%、45.5%、34.6%，差异有统计学意义（P = 0.019）；A组早期流产率（3.64%）显著低于C组（15.79%）（P < 0.01）。子宫内膜准备治疗费用方面，A组［（676.5 ± 494.5）元］显著低于B组［（2 401.2 ± 764.2）元］和C组［（3 093.8 ± 758.3）元］（P < 0.01）。 结论 薄型子宫内膜患者 FET周期中，TAM、TAM联合PRP及HRT联合PRP宫腔灌注的临床结局相似，且TAM具备早期流产率低、经济性好，可用作薄型子宫内膜患者子宫内膜准备。

Objective To compare the clinical pregnancy outcomes of tamoxifen （TAM） ， TAM combined with intrauterine perfusion of platelet-rich plasma （PRP）， and hormone replacement therapy （HRT） combined with intrauterine perfusion of PRP for frozen-thawed embryo transfer （FET） in patients with thin endometrium. Methods A retrospective analysis was performed on clinical data of 321 patients with thin endometrium （endometrial thickness ≤ 7 mm in previous cycles） who underwent FET at the Reproductive Medicine Center of Guangdong Provincial Reproductive Hospital from January 2023 to April 2025. According to the treatment protocols，the patients were divided into three groups： TAM group （Group A， n = 98）， TAM + PRP group （Group B， n = 91）， and HRT + PRP group （Group C， n = 132）. General information， endometrial thickness on the conversion day before and after treatment， clinical pregnancy outcomes， andcosts of endometrial preparation treatment were compared among the three groups. Results There were no significant differences in age， duration of infertility， type of infertility， anti-Müllerian hormone （AMH） level， basal follicle-stimulating hormone （FSH） among the three groups（P > 0.05）. After treatment， there were no significant differences in endometrial thickness on the conversion day or the extent of increase among the three groups（P > 0.05）. The clinical pregnancy rates in Group A， Group B， and Group C were 56.1%， 51.6%， and 43.2% respectively， with a significant difference （P = 0.011）； the embryo implantation rates were 43.6%， 45.5%， and 34.6% respectively， showing a significant difference（P = 0.019）. The early abortion rate in Group A （3.64%） was significantly lower than that in Group C （15.79%）（P < 0.01）. In terms of treatment cost of endometrial preparation treatment， the cost in Group A （676.5 ± 494.5 Yuan） was significantly lower than that in Group B （2 401.2 ± 764.2 Yuan） and Group C （3 093.8 ± 758.3 Yuan） （P < 0.01）. Conclusion In FET cycles for patients with thin endometrium， the clinical outcomes of TAM，TAM + PRP and HRT + PRP are comparable， and TAM demonstrates advantages in terms of a lower early miscarrage rate and better cost-effectiveness， thus serving as an option for endometrial preparation in patients with thin endometrium.