两种阴道给药黄体酮制剂在IVF-ET/ICSI中作为黄体支持的疗效评价  

Efficacy Evaluation of Two Vaginally Administered Progesterone Formulations as Luteal Support in IVF-ET/ICSI

作　　者：尹小丽 宋雅琳 侯宁 YIN Xiao-li;SONG Ya-lin;HOU Ning(Institute of Women,Children and Reproductive Health,Shandong University,Hospital for Reproductive Medicine Affiliated to Shandong University,Jinan 250012,China;Shandong Provincial Hospital Affiliated to Shandong First Medical University,Jinan 250021,China)

机构地区：[1]山东大学妇儿与生殖健康研究院/山东大学附属生殖医院,山东济南250012 [2]山东第一医科大学附属省立医院,山东济南250021

出　　处：《食品与药品》2024年第5期468-473,共6页Food and Drug

摘　　要：目的比较阴道给药黄体酮软胶囊和黄体酮阴道缓释凝胶用于体外受精-胚胎移植(IVF-ET)/卵泡浆内单精子显微注射(ICSI)过程中的黄体支持疗效。方法回顾性分析2021年1月至2022年12月于我院进行黄体期短效长方案促排卵IVF-ET/ICSI助孕的2258例患者的临床资料,根据取卵后选择的黄体支持方案的不同分为两组,A组1443个周期,采用阴道给药黄体酮软胶囊联合口服地屈孕酮片;B组815个周期,采用阴道给药黄体酮阴道缓释凝胶联合口服地屈孕酮片,比较两组患者的一般情况、HCG注射日指标及妊娠结局。结果A组和B组患者的年龄、不孕年限、体重指数(BMI)、基础内分泌水平(bFSH、bLH、bE2和bPRL)、HCG注射日内膜厚度、HCG注射日≥14 mm卵泡数、HCG注射日孕酮(P)、获卵数、移植数、着床率、生化妊娠率、临床妊娠率、多胎率、异位妊娠率、早期流产率、中晚期流产率、早产率和足月产率组间均无统计学差异(P>0.05),而A组的雌二醇(E2)值高于B组(P<0.05),差异有统计学意义。结论采用黄体期短效长方案促排卵进行IVF-ET/ICSI的患者,经阴道给药黄体酮软胶囊和黄体酮阴道缓释凝胶均能达到较理想的黄体支持作用,得到较好的妊娠结局,着床率、临床妊娠率、生化妊娠率和早期流产率等相似。Objective To compare the efficacy of vaginal administration of progesterone soft capsules and progesterone vaginal sustained-release gel for luteal support during in vitro fertilization-embryo transfer(IVF-ET)/intracytoplasmic sperm injection(ICSI).Methods A retrospective analysis was conducted on the clinical data of 2258 patients who underwent luteal phase short-acting long regimen ovulation induction and IVF-ET/ICSI assisted pregnancy in our hospital from January 2021 to December 2022.Two groups were divided according to different luteal support regimens after oocyte retrieval.Group A had 1443 cycles and received intravaginal administration of progesterone soft capsules combined with oral administration of dydrogesterone tablets.Group B consisted of 815 cycles,using intravaginal administration of progesterone vaginal sustained-release gel combined with oral administration of dydrogesterone tablets.The general condition,indicators of HCG injection day and pregnancy outcomes were compared between the patients in two groups.Results There were no statistically significant differences in age,infertility duration,body mass index(BMI),basal endocrine levels(bFSH,bLH,bE2,and bPRL),endometrial thickness on the day of HCG injection,number of follicles≥14mm on the day of HCG injection,progesterone(P)on the day of HCG injection,number of oocyte retrieval rates,number of transplants,implantation rate,biochemical pregnancy rate,clinical pregnancy rate,multiple pregnancy rate,ectopic pregnancy rate,early miscarriage rate,mid to late miscarriage rate,premature birth rate,and term birth rate between groups(P>0.05).The estradiol(E2)value of group A was higher than that of group B(P<0.05),and the difference was statistically significant.Conclusion Patients undergoing IVF-ET/ICSI using a luteal phase long regimen for ovulation induction can achieve ideal luteal support through vaginal administration of both progesterone soft capsules and progesterone vaginal sustained-release gel,resulting in better pregnancy outcomes and simil

关 键 词：黄体酮软胶囊 黄体酮阴道缓释凝胶 黄体支持 体外受精-胚胎移植 卵泡浆内单精子显微注射 妊娠结局 

分 类 号：R944.9[医药卫生—药剂学] R979.23[医药卫生—药学]