黄体酮胶囊用于新鲜胚胎移植中黄体支持的临床研究  

Clinical Study of Progesterone Capsule for Luteal Phase Support in Fresh Embryo Transfer

作　　者：高金梅 王婷[1] 袁莹莹[2] 赵君利[2] GAO Jinmei;WANG Ting;YUAN Yingying;ZHAO Junli(Ningxia Medical University,Yinchuan 750004,China;the General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院,银川750004

出　　处：《宁夏医科大学学报》2023年第8期799-803,共5页Journal of Ningxia Medical University

基　　金：国家重点研发计划项目(2021YFC2700404)。

摘　　要：目的探讨新鲜胚胎移植中不同黄体支持方案对妊娠结局及子代情况的影响,评估黄体酮胶囊用于黄体支持的安全性、有效性及经济效益。方法回顾性分析2018年12月至2020年4月就诊于宁夏医科大学总医院生殖医学中心行体外受精胚胎移植(IVF-ET)助孕的患者共265个周期,按照不同黄体支持方案将患者分为4组:A组(n=120)采用黄体酮阴道缓释凝胶,90 mg/次,每天1次,联合口服地屈孕酮,10 mg/次,每天2次;B组(n=49)口服黄体酮胶囊,200 mg/次,每天2次;C组(n=51)口服黄体酮胶囊,200 mg/次,每天3次;D组(n=45)采用黄体酮阴道缓释凝胶,90 mg/次,每天1次。比较各组间患者的一般情况、促排卵情况、胚胎移植情况、妊娠结局、子代情况及经济效益等指标。结果各组患者一般情况、促排卵情况、胚胎移植情况比较差异均无统计学意义(P均>0.05)。4组患者妊娠结局、子代情况比较,其中早产率和双胎活产率差异均有统计学意义(P均<0.05),其余无统计学意义(P均>0.05)。4组成本-效果比:A组59.85,B组10.45,C组15.46,D组66.60。在本研究临床资料收集过程中未发现与药物相关不良反应记录。结论黄体酮阴道缓释凝胶联合地屈孕酮、黄体酮胶囊、黄体酮阴道缓释凝胶均为新鲜胚胎移植周期中安全有效的黄体支持方案;黄体酮胶囊200 mg/次,每天3次,能够提供有效的黄体支持并具有明显经济效益优势。Objective To investigate the effects of different luteal support regimens in fresh embryo transfer on pregnancy outcome and offspring status and to assess the safety,efficacy and economic benefits of Progesterone Capsule for luteal support.Methods A total of 265 cycles of patients attending to the Reproduction Medicime Centre of the General Hospital of Ningxia Medical University for IVF-ET(in vitro fertilization-embryo transfer),assisted pregnancy and fresh embryo transfer from December 2018 to April 2020 were retrospectively analyzed and patients were divided into four groups according to different luteal support regimens,Group A(n=120):Progesterone Vaginal Extended Release Gel(Crinone)90 mg per day+Dydrogesterone 10 mg 2 time per day.Group B(n=49):Progesterone Capsule 200 mg 2 time per day.Group C(n=51):Progesterone Capsule 200 mg 3 time per day.Group D(n=45):Progesterone Vaginal Extended Release Gel 90 mg per day.The general condition,ovulation promotion,embryo transfer,pregnancy outcome,offspring condition,economic benefit and other indicators were compared among the patients in each group.Results The differences in general condition,ovulation induction and embryo transfer between the four groups were not statistically significant(P all>0.05).The differences in pregnancy outcome and offspring between the four groups were not statistically significant(P all>0.05),except preterm birth rates and twin live birth rates were statistically significant(P all<0.05).The cost-effectiveness ratios of the four groups were A=59.85,B=10.45,C=15.46 and D=66.60 respectively.No drug-related adverse reactions were recorded during the collection of clinical data for this study.Conclusion Progesterone Vaginal Extended Release Gel combined with Dydrogesterone,Progesterone Capsule and Vaginal Extended Release Gel were safe and effective luteal support regimens in fresh embryo transfer.Progesterone Capsule 200 mg 3 time per day was able to provide effective luteal support and had obvious economic benefits.

关 键 词：新鲜胚胎移植 黄体支持 黄体酮 妊娠结局 子代情况 

分 类 号：R714.8[医药卫生—妇产科学]