不同黄体支持对拮抗剂方案新鲜胚胎移植周期妊娠结局的影响  

Effects of different luteal phase supports on the outcomes of fresh embryo transfer in GnRH antagonist cycles

作　　者：周莉娜[1] 吴煜[1] 高晓红[1] 陈威[1] ZHOU Li-na;WU Yu;GAO Xiao-hong;CHEN Wei(Department of Reproductive Medicine,Shanghai General Hospital,Shanghai Jiaotong University School of Medicine,Shanghai201620)

机构地区：[1]上海交通大学附属第一人民医院辅助生殖医学科,上海201620

出　　处：《生殖医学杂志》2019年第2期103-106,共4页Journal of Reproductive Medicine

摘　　要：目的比较两种不同黄体支持对促性腺激素释放激素拮抗剂(GnRH-ant)方案新鲜胚胎移植周期妊娠结局的影响,探讨更合理的黄体支持方案。方法回顾性分析2016年1月至2017年12月在我科采用GnRH-ant方案促排卵行新鲜胚胎移植患者的临床资料,共631个周期,按不同黄体支持分为两组:黄体酮阴道缓释凝胶(雪诺同,90mg/d)为雪诺同组(331周期);肌注黄体酮(40mg/d)为黄体酮组(300周期)。分析两组间妊娠率、继续妊娠率等治疗结局的差异。结果两组患者年龄、BMI、不孕年限、基础内分泌水平等一般资料均无统计学差异(P>0.05);雪诺同组与黄体酮组比较,种植率(28.7%vs.29.2%)、临床妊娠率(42.3%vs.42.7%)、继续妊娠率(34.4%vs.34.7%)、多胎妊娠率(30.0%vs.30.5%)、流产率(12.9%vs.13.3%)以及异位妊娠率(5.7%vs.5.5%)均无统计学差异(P>0.05)。结论在GnRH-ant方案新鲜胚胎移植周期中,黄体酮阴道缓释凝胶进行黄体支持可获得与肌注黄体酮相似的种植率、妊娠率及继续妊娠率,且不增加流产的发生。Objective:To compare the effects of two different luteal phase support protocols on the outcomes of fresh embryo transfer in GnRH antagonist cycle,and explore a more reasonable protocol of luteal phase support.Methods:The clinical data of 631 cycles in our department from January 2016 to December 2017 were retrospectively analyzed.The cycles were divided into two groups according to different luteal phase support protocols:progesterone vaginal gel(Crinone,90 mg/day)was used in group A(n=331)and intramuscular progesterone in oil(40 mg/day)was administrated in group B(n=300).The pregnancy rate and continuous pregnancy rate were compared between the two groups.Results:There were no significant differences in age,BMI,infertility years,and basic endocrine levels between the two groups(P >0.05).There were also no significant differences in implantation rate(28.7%vs.29.2%),clinical pregnancy rate(42.3%vs.42.7%),continuous pregnancy rate(34.4%vs.34.7%),multiple pregnancy rate(30.0%vs.30.5%),abortion rate(12.9%vs.13.3%)and ectopic pregnancy rate(5.7%vs.5.5%)between the two groups(P >0.05).Conclusions:In the fresh embryo transfer cycle with GnRH antagonist protocol,progesterone vaginal gel for luteal phase support can obtain similar implantation rate,pregnancy rate and continuous pregnancy rate as compared with intramuscular progesterone,and does not increase the incidence of miscarriage.

关 键 词：促性腺激素释放激素拮抗剂 黄体酮阴道缓释凝胶 肌注黄体酮 体外受精-胚胎移植 妊娠结局 

分 类 号：R711.6[医药卫生—妇产科学]