黄体酮阴道缓释凝胶配伍减量肌注黄体酮在体外受精-胚胎移植技术中的应用研究  

The clinical research of progesterone vaginal gel associated with reduction of intramuscular progesterone protocol in vitrofertilization-embryo transfer

作　　者：巨瑛[1] 吴静[1] 黄剑磊[1] 刘芳[1] 马夜肥[1] 王晓红[1] 

机构地区：[1]第四军医大学唐都医院妇产科,西安710038

出　　处：《陕西医学杂志》2016年第5期519-521,共3页Shaanxi Medical Journal

基　　金：国家自然科学基金资助面上项目(81370710)

摘　　要：目的：探讨在体外受精胚胎移植技术中黄体酮阴道缓释凝胶联合减量肌注黄体酮方案对妊娠结局的影响。方法：采用黄体酮阴道缓释凝胶联合减量肌注黄体酮方案（研究组）进行黄体支持的IVF-ET共1556个周期,与同期常规肌注黄体酮方案（对照组）进行黄体支持的IVF-ET共1553个周期,比较两种黄体支持方案的有效性。结果：在治疗效果中,〈35岁组与35~39岁组两种治疗方案在着床率、临床妊娠率及异位妊娠率方面均无显著性差异（P〉0.05）;在早期流产中,〈35岁研究组早期流产率为4.8%,对照组早期流产率为11.3%;35~39岁研究组早期流产率为4.5%,对照组早期流产率为23.7%,两组早期流产率比较均有显著性差异（P〈0.05）,且以年龄35~39岁差异更大（P〈0.01）。结论：黄体酮阴道缓释凝胶联合减量肌注黄体酮方案与常规单用肌注黄体酮相比,在保持着床率及临床妊娠率的前提下,能够降低早期流产率的发生,是一种有效易行的黄体支持方案。Objective： To study the effects of progesterone vaginal gel associated with reduction of intra- muscular progesterone luteal support protocol on pregnant outcomes with in vitro fertilization-embryo transfer. Methods： In this study, IVF-ET 1556 cycles from Jan. 2010 to Jul. 2012 with progesterone vaginal gel combined with reduction of intramuscular progesterone protocols（study group）, and 1553 cycles with conventional intramuscu- lar progesterone protocols（control group） were analyzed retrospectively. Results： In both 〈 35y and 35 ~ 39y groups,there were no statistical differences between the two luteal support protocols in implantation rates, clinical pregnancy rates and ectopic pregnancy rates. But both of the early abortion rates, in 〈35y cycles study group 4.8 %, control group 11.3%, and in 35~39y cycles study group 4.5%, control group 23.7%, were significant differ- ence. Conclusion： The luteal support protocol of progesterone vaginal gel combined with reduction of intramuscular progesterone not only has the same implantation rates, clinical pregnancy rates and ectopic pregnancy rates with con- ventional intramuscular progesterone protocol, but also could reduce the early abortion rate. It seemed to be more ef- fective and convenient for pregnant outcomes.

关 键 词：受精 体外 胚胎移植 黄体保持 妊娠结局 

分 类 号：R714.13[医药卫生—妇产科学]