卵巢低反应人群应用不同剂量地屈孕酮行高孕酮状态下促排卵方案的临床结局比较  

Comparison of clinical outcomes of different doses of progesterone in progestin-primed ovarian stimulation protocol for patients with poor ovarian response

作　　者：倪冬冬 黄影 尚进 杨静[1] 金丹 张兰梅 NI Dong-dong;HUANG Ying;SHANG Jin;YANG Jing;JIN Dan;ZHANG Lan-mei(Reproductive Medical Center,the Ninth Medical Center of PLA General Hospital,Beijing 100101)

机构地区：[1]中国人民解放军总医院第九医学中心生殖医学中心,北京100101

出　　处：《生殖医学杂志》2024年第8期997-1001,共5页Journal of Reproductive Medicine

基　　金：博士毕业生科研启动基金(21ZX14)。

摘　　要：目的比较高孕酮状态下促排卵(PPOS)方案应用于卵巢低反应(POR)人群时,给予20 mg/d地屈孕酮口服与30 mg/d地屈孕酮口服的临床结局。方法回顾性分析2017年1月至2022年12月在本中心进行体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)助孕治疗的114例患者的临床资料(共114个周期)。并根据使用的地屈孕酮剂量不同,分为地屈孕酮20 mg组(20个周期)和30 mg组(94个周期)。比较两组患者的一般资料、促排卵情况、胚胎移植情况及临床结局。结果两组患者的女方年龄、体质量指数(BMI)、不予年限等一般资料比较均无显著性差异(P>0.05)。两组患者的促性腺激素(Gn)用量、Gn使用天数、获卵数、MⅡ卵数、扳机日LH水平及可用胚胎数比较均无显著性差异(P>0.05)。两组患者冻融胚胎移植(FET)周期的临床妊娠率、活产率及流产率比较亦无显著性差异(P>0.05)。结论对于POR患者,PPOS方案中给予地屈孕酮20 mg口服可获得与地屈孕酮30 mg口服相似的临床结局,且地屈孕酮20 mg口服可减少药物使用量,节约用药成本,值得临床关注。但本研究样本量较小,后续仍需进一步扩大样本量、完善研究设计后进行深入探讨。Objective:To compare the clinical outcomes of 20 mg and 30 mg of dydrogesterone in the progestin-primed ovarian stimulation(PPOS)protocol for patients with poor ovarian response(POR).Methods:A retrospective study on clinical outcomes of 114 treatment cycles was conducted in 114 patients who underwent IVF/ICSI-ET in Reproductive Medical Center,Strategic Support Force Medical Center between January 2017 and December 2022.According to the dose of dydrogesterone,they were divided into 20 mg of dydrogesterone group with 20 cycles and 30 mg of dydrogesterone group with 94 cycles.The basic characteristics,ovulation induction,embryo transfer,and clinical outcomes were evaluated.Results:There were no significant differences in basic characteristics,body mass index,duration of infertility between the two groups(P>0.05).Moreover,there were no significant differences in the dose of gonadotropin(Gn),the duration of Gn use,the number of oocyte retrieved,the number of MⅡoocyte,LH level on the trigger day,the number of available embryos between the two groups(P>0.05).There was no significant difference in the clinical pregnancy rate,live birth rate,and miscarriage rate between the two groups of frozen thawed embryo transfer(FET)cycles(P>0.05).Conclusions:For POR patients,similar clinical outcomes were obtained with 20 mg of dydrogesterone and 30 mg of dydrogesterone in the PPOS protocol.Dydrogesterone 20 mg orally can significantly reduce the drug dosage and save the cost of drug,which is worthy of clinical attention.However,the sample size of this study is relatively small,and further exploration is needed after expanding the sample size and improving the research design.

关 键 词：地屈孕酮 高孕酮状态下促排卵 卵巢低反应 

分 类 号：R711.6[医药卫生—妇产科学]