摘要
目的观察冻融胚胎移植(FET)中不同激素代替治疗(HRT)周期用药策略对妊娠结局的影响。方法选择FET周期内运用HRT方案治疗的110例患者作为研究对象,依照用药方案的不同分为Ⅰ组(35例)、Ⅱ组(30例)、Ⅲ组(45例)。Ⅰ组患者采用补佳乐治疗,Ⅱ组患者采用芬吗通治疗,Ⅲ组患者采用芬吗通联合阴道给药治疗。比较三组患者的雌激素总用药量、用药疗程、转化日雌二醇(E_(2))水平及临床妊娠率,并分析HRT周期中雌激素用药策略和妊娠率的相关性。结果共采集到826个FET周期,其中807个成功完成,19个被取消,取消率为2.30%(19/826)。三组用药疗程、临床妊娠率比较差异无统计学意义(P>0.05);三组雌激素总用药量、转化日E_(2)水平比较差异均有统计学意义(P<0.05)。雌激素总用药量、用药疗程、转化日E_(2)水平和妊娠率的拟合度分别为8.8%、10.6%、4.7%,德宾-沃森(D-W)对应值依次为1.346、1.109、1.697,雌激素总用药量、用药疗程和妊娠率均存在着序列相关性(P<0.05),而转化日E_(2)水平和妊娠率无序列相关关系(P>0.05)。结论胚胎着床、妊娠成功率增加的重要条件是创造适宜的雌孕激素环境,采用HRT方案时维持一定的用药疗程和用药总量就能够抵达一定的妊娠率。
Objective To observe the effect of different medication strategies on pregnancy outcome during different hormone replacement therapy (HRT) cycle of frozen-thawed embryo transfer (FET).Methods 110 patients treated with HRT regimen during FET cycle were selected for the study,and were divided into group Ⅰ (35 patients),group Ⅱ (30 patients),and group Ⅲ (45 patients) according to different medication regimens.Patients in group I were treated with Progynova,patients in group Ⅱ were treated with Femoston,and patients in group Ⅲ were treated with Femoston and vaginal administration.The total dose of estrogen,course of medication,estradiol (E_(2)) level on transformation day and clinical pregnancy rate were compared among the three groups,and the correlation between estrogen medication strategy and pregnancy rate during HRT cycle was analyzed.Results A total of 826 FET cycles were collected,of which 807 cycles were successfully completed and 19 cycles were cancelled,with a cancellation rate of 2.30%(19/826).There was no statistically significant difference in the course of medication and clinical pregnancy rate among the three groups (P>0.05).There were statistically significant differences in total dose of estrogen and E_(2)level on the transformation day among the three groups (P<0.05).The fitting degree of total dose of estrogen,course of medication,E_(2)level on the transformation day and pregnancy rate were 8.8%,10.6% and 4.7%,respectively,with Durbin-Watson (D-W) corresponding values of 1.346,1.109 and 1.697,respectively,and there was a sequence correlation between total dose of estrogen,course of medication and pregnancy rate (P<0.05),while there was no sequence correlation between E_(2)level on the transformation day and pregnancy rate (P>0.05).Conclusion The important condition for embryo implantation and increased pregnancy success is the creation of a suitable estrogen and progesterone environment.A certain pregnancy rate can be achieved by maintaining a certain course of medication and total amount
作者
陈洁
曾惠明
CHEN Jie;ZENG Hui-ming(Centre for Reproductive Medicine,Wuxi Maternity and Child Health Hospital,Wuxi 214002,China)
出处
《中国现代药物应用》
2022年第24期118-121,共4页
Chinese Journal of Modern Drug Application
关键词
冻融胚胎移植
激素代替治疗周期
雌激素用药
妊娠结局
Frozen-thawed embryo transfer
Hormone replacement therapy cycle
Estrogen administration
Pregnancy outcome
