摘要
目的比较口服地屈孕酮片和阴道用黄体酮凝胶在拮抗剂方案鲜胚移植黄体支持中的临床疗效。方法回顾性分析2015年至2020年在香港大学深圳医院生殖医学中心实施拮抗剂方案鲜胚移植的患者共774例,其中口服地屈孕酮黄体支持399例,阴道放置黄体酮凝胶黄体支持375例。利用倾向评分匹配(PSM)通过1∶1最近邻匹配调整混杂因素,对两组临床疗效进行分析比较。结果匹配后两组各337例,匹配后口服地屈孕酮片组促性腺激素(Gn)总量高于阴道黄体酮凝胶组,差异有统计学意义(t=3.643,P<0.05);两组年龄、体质量指数、不孕年限、获卵总数、总窦卵泡数、血清促卵泡激素(FSH)、促黄体生成素(LH)、雌二醇(E)、孕酮(P)、泌乳素(PRL)、睾酮(T)、移植胚胎数目差异均无统计学意义(P>0.05),匹配后口服地屈孕酮组早产率低于阴道黄体酮凝胶组,差异有统计学意义(χ^(2)=3.981,P<0.05);两组流产率、异位妊娠率、多胎率、卵巢过度刺激综合征(OHSS)发生率、活产率、临床妊娠率差异均无统计学意义(P>0.05)。结论拮抗剂方案新鲜周期移植后口服地屈孕酮片黄体支持与阴道黄体酮凝胶的黄体支持,其临床妊娠率和活产率没有明显统计学差异,单用口服地屈孕酮片可以成为体外受精-胚胎移植新鲜周期黄体支持的新选择。
Objective To compare clinical efficiency of oral dydrogesterone tablets and vaginal progesterone gel placement in fresh embryo transfer cycle luteal phase support with gonadotropin release hormone(GnRH)antagonist protocol.Methods A retrospective analysis was performed on 774 patients who underwent in vitro fertilization-fresh embryo transfer(IVF-ET)with GnRH antagonist protocol from 2015 to 2020,including 399 patients who were prescribed with oral dydrogesterone as luteal phase support and were allocated to experimental group,and 375 patients who were prescribed with vaginal progesterone gel placement as luteal phase support and were allocated to control group.1:1 nearest-neighbor matching in propensity score matching(PSM)was used to adjust for confounding factors.The clinical efficiencies of the two prescriptions were analyzed and compared between the two groups.Results There were 337 cases in each of the two groups after matching,and the total amount of gonadotropin(Gn)in the matched oral dydrogesterone tablet group was higher than that in the vaginal progesterone gel placement group,and the difference was statistically significant(t=3.643,P<0.05).There were no significant differences in age,body mass index(BMI),infertility years,total number of egg acquisitions,antral follicle count(AFC),serum levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E),progesterone(P),prolactin(PRL)and testosterone(T),and the number of embryos transferred between the two groups(all P>0.05).The preterm birth rate in the matched oral dydrogesterone group was lower than that in the vaginal progesterone gel placement group,and the difference was statistically significant(χ^(2)=3.981,P<0.05),There were no significant differences in miscarriage rate,ectopic pregnancy rate,multiple birth rate,ovarian hyperstimulation syndrome(OHSS)rate,live birth rate,and clinical pregnancy rate between the two groups(all P>0.05).Conclusion In clinical pregnancy rate and live birth rate following luteal phase support with GnRH a
作者
黄园斐
丁书芳
林苏霞
黄林芬
何柏松
叶天民
HUANG Yuanfei;DING Shufang;LIN Suxia;HUANG Linfen;He Pak Chung;Ye Tian-Min(Center of Reproductive Medicine,Shenzhen Hospital of Hong Kong University,Guangdong Shenzhen 518053,China)
出处
《中国妇幼健康研究》
2023年第6期69-74,共6页
Chinese Journal of Woman and Child Health Research
关键词
地屈孕酮片
黄体酮凝胶
拮抗剂方案
鲜胚移植
黄体支持
dydrogesterone
progesterone gel
GnRH antagonist protocol
fresh embryo transfer
luteal phase support
