黄体酮阴道缓释凝胶在IVF/ICSI-ET周期作为黄体支持的临床结局  

Clinical Outcome of Vaginal Gel Progesterone for Luteal Phase Support in IVF/ICSI-ET

作　　者：季晓微[1] 洪燕[1,2] 赵晓明[1,2] 高敏芝[1,2] 王杨[1] 何亚琼[1] 孙赟[1,2] 

机构地区：[1]上海交通大学医学院附属仁济医院生殖医学中心,上海200135 [2]上海市辅助生殖与优生重点实验室,上海200135

出　　处：《生殖与避孕》2014年第5期363-367,共5页Reproduction and Contraception

基　　金：国家自然科学基金面上项目(编号:81370762);上海市科委基础研究重点项目(编号12JC1405800);国家科技部重大科学研究计划(编号:2014CB943302);卫生部公益性行业科研专项(编号:201402004)

摘　　要：目的:探讨新鲜胚胎移植周期黄体酮阴道缓释凝胶作为黄体支持的临床效果。方法:回顾性分析接受IVF/ICSI助孕的行新鲜胚胎移植患者的临床资料,统计分析3 193个周期采用黄体酮阴道缓释凝胶行黄体支持(A组)者的临床妊娠率和活产率,并与肌肉注射黄体酮行黄体支持的813个周期(B组)进行比较,同时进一步按长、短、拮抗剂方案进行分层分析。结果:活产率A组为34.3%,B组为34.9%,组间无统计学差异(P>0.05),临床妊娠率和流产率组间也均无统计学差异(P>0.05)。活产率分层分析显示,长方案A组为40.0%,B组为40.3%;短方案A组为25.9%,B组为28.3%,拮抗剂方案A组为28.3%,B组为28.8%,两两比较均无统计学差异(P>0.05),临床妊娠率和流产率也均无统计学差异(P>0.05)。结论:作为IVF/ICSI-ET周期的黄体支持,黄体酮阴道缓释凝胶临床效果与肌肉注射黄体酮相同,阴道凝胶给药是一种可行的替代肌肉注射的黄体支持方式。Objective： To explore the clinical effect of vaginal gel progesterone for luteal phase support in fresh embryo transfer cycles. Methods： A total of 4 006 cases receiving IVF/ICSI in fresh embryo transfer cycles were included in this retrospective study. Among them 3 193 cycles were administered vaginal gel progesterone for luteal phase support （group A）; while 813 cycles adopted intramuscular proges- terone （group B）. The clinical outcomes were compared between the two groups. All these cases were divided into 3 subgroups according to different protocols （long, short and GnRH antagonist protocol）. Results： The live birth rate was not significantly different in group A （34.3%） and group B （34.9%） （P〉0.05）. The two study groups did not differ significantly in clinical pregnancy rate and abortion rate （P〉0.05）. Analyzing in long protocol, live birth rate was 40.0% in group A and 40.3% in group B. Analyzing in short protocol, live birth rate was 25.9% in group A and 28.3% in group B. Analyzing in GnRH antagonist protocol, live birth rate was 28.3% in group A and 28.8% in group B. There was no significant difference between the two groups in any protocol （P〉0.05）. The clinical pregnancy rate and abortion rate was similar between the two groups in any protocol （P〉0.05）. Conclusion： The clinical effect of vaginal gel progesterone for luteal phase support in fresh embryo transfer cycles was the same as that of intramuscular progesterone. Vaginal gel dosing is a viable alternative to intramuscular for luteal support.

关 键 词：黄体酮 阴道缓释凝胶 肌肉注射 黄体支持 体外受精(IVF) 卵胞质内单精子注射(ICSI) 

分 类 号：R714.8[医药卫生—妇产科学]