两种黄体支持药物对体外受精临床疗效的分析  

Analysis of clinical effect of two luteal support drugs on in vitro fertilization

作　　者：朱丹丹[1] 张立新[1] 陈新萍[1] 汪佳[1] 张萍[1] 葛红山 ZHU Dandan;ZHANG Lixin;CHEN Xinping;WANG Jia;ZHANG Ping;GE Hongshan(People's Hospial of Taizhou.Jiangsu Taizhou 225300,China)

机构地区：[1]泰州市人民医院,江苏泰州225300

出　　处：《中国妇幼健康研究》2020年第7期975-978,共4页Chinese Journal of Woman and Child Health Research

基　　金：江苏省自然科学基金资助项目(BK20171317)

摘　　要：目的 探讨两种阴道用的黄体支持药物黄体酮阴道缓释凝胶和黄体酮软胶囊在临床辅助生殖治疗中的应用效果.方法 选取2017年1月至2018年12月期间在泰州市人民医院接受体外受精-胚胎移植(IVF-ET)/卵细胞浆内单精子注射受精(ICSI)助孕的不孕患者共272例为研究对象,并对其临床病历资料进行回顾性分析.按照不同黄体支持药物,将其分为研究1组(黄体酮阴道缓释凝胶,n=136)和研究2组(黄体酮软胶囊,n=136).比较两组患者新鲜移植周期的临床妊娠率、活产率、流产率及异位妊娠率等指标.结果 研究1组28~34岁年龄段和35~39岁年龄段的临床妊娠率均显著高于研究2组(69.7%v s.50.7%65.0%v s.36.5%),其活产率也均显著高于研究2组(96.2%v s.78.4%,94.9%v s.47.8%),组间比较差异均存在统计学意义(χ2值分别为5.651、9.980、5.337、18.317,均P<0.05).研究1组35~39岁年龄段的早期流产率显著低于研究2组(5.1%v s.43.5%),组间比较差异存在统计学意义(χ2=11.286,P<0.05);而两组患者该年龄段的晚期流产率比较差异无统计学意义(P>0.05).结论 黄体酮阴道缓释凝胶在提高临床妊娠率和活产率方面优于黄体酮软胶囊,同时可以降低高龄患者的早期流产率.Objective To investigate the clinical efficacy of the two most common vaginal progesterone support drugs,including progesterone vaginal sustained-release gels and progesterone soft capsule,in assisted reproduction.Methods From January 2017 to December 2018,a total of 272 infertility patients who received in vitro fertilization-embryo transfer(IVF-ET)/intracytoplasmic sperm injection(ICSI)treatment in People’s Hospital of Taizhou were selected as the research subjects.A retrospective analysis of the clinical medical records was performed.According to the different luteum supporting drugs,they were divided into group 1(with progesterone vaginal sustained-release gels,n=136)and group 2(with progesterone soft capsule,n=136).The clinical pregnancy rate,live birth rate,abortion rate,and ectopic pregnancy rate were compared between the two groups during the fresh transplant cycle.Results The clinical pregnancy rates of 28-34 age group and the 35-39 age group in the Group 1 were significantly higher than those in the Group 2(69.74%vs.50.68%,65.00%vs.36.51%),the live birth rates of Crinone in those two age groups were also significantly higher than those in the Group 2(96.23%vs.78.38%,94.87%vs.47.83%),and the differences were statistically significant(χ~2=5.651,9.980,5.337 and 18.317,respectively,all P<0.05).The early abortion rate of Group 1 in the 35-38 age group was significantly lower than that in the Group 2(5.13%vs.43.48%),the difference was statistically significant(χ~2=11.286,P<0.05).But no statistical difference was found in the late abortion rate between the two groups(P>0.05).Conclusions Progesterone vaginal sustained-release gel is superior to progesterone soft capsule in improving clinical pregnancy rate and live birth rate,which can reduce early abortion rate of elderly patients.

关 键 词：阴道用药 黄体支持药物 体外受精 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]