黄体酮阴道缓释凝胶在多周期IVF/ICSI-ET黄体支持中的应用价值  

The Efficacy of Progesterone Sustained-Release Vaginal Gel as Luteal Phase Support in Repeated IVF/ICSI Cycles

作　　者：邹红艳[1] 李维麟[1] 王细林[1] 吴方贵[1] 彭南妮[1] 

机构地区：[1]广东省深圳市罗湖区人民医院,广东深圳518000

出　　处：《实用妇产科杂志》2013年第4期312-315,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:比较多周期体外受精/卵细胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)后应用3种不同剂型黄体酮行黄体支持对妊娠结局的影响,为临床用药提供参考。方法:回顾性分析2009年1月至2012年3月670个IVF或ICSI助孕周期469例患者的临床资料,根据行不同的黄体支持分为黄体酮油剂组(A组)、黄体酮阴道栓剂组(B组)和黄体酮阴道缓释凝胶组(C组)。比较3组在不同的助孕周期(第2、第3、第4和第5周期及以上)的临床妊娠率、异位妊娠率、多胎妊娠率和早期流产率。结果:多周期IVF/ICSI助孕时,在第2、3周期中,C组多胎妊娠率均高于A组和B组(P<0.05);在第4周期和第5周期及以上时,C组的临床妊娠率高于A组和B组(P<0.05);各组的异位妊娠率和早期流产率比较,差异无统计学意义(P>0.05)。A组有6例发生了局部的变态反应,其中1例为严重的局部变态反应,其余两组无全身及局部的不良反应;3组阴道少量流血发生率比较,差异无统计学意义(P>0.05)。结论:对患者行多周期IVF/ICSI助孕,黄体酮阴道缓释凝胶比肌内注射黄体酮油剂及黄体酮阴道栓剂用于黄体支持具有免受针剂治疗的痛苦,不良反应小,使用更加方便,临床效果相对较好的特点。Objective：To compare the efficacy of luteal phase support by three progesterone preparations in repeated IVF/ICSI cycles in order to provide evidence to clinical medication. Methods：The clinical data of 670 IVF/ICSI cycles （469 patients） from January 2009 to March 2012 in our hospital were retrospectively analyzed. According to different luteal phase supports,cycles were classified into 3 groups. Group A： Proges- terone oil via intramuscular injection route. Group B： Progesterone suppository via vaginal route. Group C： Progesterone sustained-release gel via vaginal route. The pregnancy outcomes including clinical pregnancy rates,ectopic pregnancy rates,multiple pregnancy rates and early abortion rate in different ART cycles sub- groups （2nd ,3 rd ,4 th ,5 th and above cycles） were compared among these three groups. Results：In the 2 nd, 3 rd cycles subgroups,multiple pregnancy rate was significantly higher in group C than that in group A or B （P 〈0.05）. In repeated cycles （≥4th time）,the clinical pregnancy rate in group C was significantly higher than that in group A or B （ P 〈 0.05）. There was no significant difference among three groups in ectopic pregnancy rate and early abortion rate （ P 〉 0.05）. 6 cases in group A experienced local allergic reaction, one of whom was judged as serious, no systemic and local adverse reactions occurred in the other two groups; There was no statistical significance among 3 groups on vaginal bleeding （ P 〉 0.05）. Conclusions： As to patients for repeated cycles of IVF/ICSI assisted reproduction,compared to intramuscular injection or suppository vaginal administration,progesterone sustained-released vaginal gel as luteal phase support is a more convenient and efficient method without intramuscular injection pain and local adverse reaction.

关 键 词：体外受精-胚胎移植 黄体支持 黄体酮阴道缓释凝胶 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]