辅助生殖技术中阴道局部给药黄体支持方案中血清低孕酮水平的临床疗效研究

发布时间：2018-06-27 12:20

本文选题：辅助生殖技术(ART) + 黄体支持　；参考：《中华生殖与避孕杂志》2017年11期

【摘要】：目的探讨辅助生殖技术(ART)中阴道局部给药的黄体支持方案血清低孕酮(P)水平对临床疗效的影响。方法选取2012年6月—2016年12月期间行激素替代方案冻融胚胎移植(FET)的624个周期,按照移植后黄体支持方案的不同分为A组(黄体酮阴道缓释凝胶+地屈孕酮组,348个周期)和B组(黄体酮针剂+地屈孕酮组,276个周期),比较组间、组内移植14 d妊娠与非妊娠者的血清P水平及妊娠结局。结果 (1)移植14 d A组中妊娠者与非妊娠者血清P水平无统计学差异(P0.05),B组中妊娠者血清P水平[(74.08±24.80)nmol/L]明显高于非妊娠者[(62.28±29.34)nmol/L],差异有统计学意义(P0.05)。(2)A组妊娠者的P水平[(16.07±9.40)nmol/L]明显低于B组,差异有统计学意义(P0.05)。(3)胚胎着床率、临床妊娠率、早期流产率、异位妊娠率组间无统计学差异(P0.05)。结论黄体酮阴道缓释凝胶作为黄体支持应用于胚胎移植术后,与肌肉注射黄体酮具有相似的临床疗效,但由于其具有子宫首过效应,血清中表达水平低,无需进行血清P水平的监测。
[Abstract]:Objective to investigate the effect of serum low progesterone (P) level on the clinical efficacy of vaginal local administration of luteal support regimen in assisted reproductive technique (art). Methods 624 cycles of frozen-thawed embryo transfer (FET) were selected from June 2012 to December 2016. According to the different protocols of luteal support after transplantation, they were divided into two groups: group A (progesterone vaginal sustained release gel group, 348 cycles) and group B (progesterone injection group, 276 cycles). The serum P level and pregnancy outcome of 14-day and non-gravid grafts in the group. Results (1) there was no significant difference in serum P levels between pregnant and non-pregnant women in group A (P0.05). The serum P level in group B [(74.08 卤24.80) nmol / L] was significantly higher than that in non-pregnancy group [(62.28 卤29.34) nmol / L], and the difference was statistically significant (P0.05) in group A [(16.07 卤9.40) nmol / L]. There was no significant difference in embryo implantation rate, clinical pregnancy rate, early abortion rate and ectopic pregnancy rate between the two groups (P0.05). Conclusion progesterone vaginal sustained-release gel has similar clinical effect as intramuscular injection of progesterone when it is used as luteal support in embryo transplantation, but its expression level is low because of its first uterine effect. There was no need to monitor the serum P level.
【作者单位】：浙江大学医学院附属妇产科医院生殖医学中心;浙江省湖州市妇幼保健院生殖医学中心;
【分类号】：R714.8

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