南方医科大学学报 ›› 2013, Vol. 33 ›› Issue (06): 861-.

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口服地屈孕酮对冻融胚胎移植周期临床妊娠结局的影响

郭薇,陈薪,叶德盛,何于夏,黎璞,牛静,杨新红,唐妍,陈士岭   

  • 出版日期:2013-06-20 发布日期:2013-06-20

Effects of oral dydrogesterone on clinical outcomes of frozen-thawed embryo transfer cycles

  • Online:2013-06-20 Published:2013-06-20

摘要: 目的探讨口服地屈孕酮片在冻融胚胎移植(FET)周期中进行黄体支持对临床结局的影响。方法对2010年1月~2011年
9 月于我中心施行的1643 例FET周期进行回顾性病例对照分析。患者按所采用的治疗方案不同进行分组:A组为自然周期
FET,B组为激素替代周期(HRT)FET。A、B组又按黄体支持用药方案不同各分为两个亚组,其中A(Ⅰ)组使用地屈孕酮片(n=
358 例),A(Ⅱ)组使用黄体酮(n=634 例);B(Ⅰ)组使用地屈孕酮片+补佳乐(n=185 例),B(Ⅱ)组使用黄体酮+补佳乐(n=466
例)。分别比较A、B两组中Ⅰ和Ⅱ方案对临床结局的影响。结果1643个FET周期,在A、B两组中Ⅰ和Ⅱ两种黄体支持用药方
案中,临床妊娠率、胚胎种植率、早期流产率、异位妊娠率、继续妊娠率均无统计学差异(P>0.05)。结论在FET周期中,应用口
服地屈孕酮片进行黄体支持可达到与黄体酮针剂相同的临床结局,在FET的黄体支持中可用地屈孕酮片替代黄体酮针剂。

Abstract: Objective To investigate the effects of oral dydrogesterone for luteal phase support after frozen embryo transfer
(FET) cycles on the clinical outcomes. Methods A total of 1643 FET cycles in our center between January, 2010 and September,
2011 were analyzed. The patients were divided into group A with natural-cycle FET and group B with hormone replacement
cycle (HRT-FET). The two groups were further divided into two subgroups to receive oral dydrogesterone (groups AI and BI,
n=358 and 185, respectively) or intramuscular progesterone with progynova (groups AII and BII, n=634 and 466, respectively)
as luteal phase support. The clinical pregnancy rates, implantation rates, early miscarriage rates, ectopic pregnancy rates,
ongoing pregnancy rates and delivery rates were compared between the subgroups. Results There were no significant
differences in the clinical outcomes between the patients receiving dydrogesterone and intramuscular progesterone as luteal
phase support in either natural-cycle FET or HRT FET (P>0.05). Conclusion In the FET cycles, oral dydrogesterone tablets for
luteal support can achieve good clinical outcomes comparable with those by intramuscular progesterone and serves as a good
alternative for luteal phase support.