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目的探讨以黄体酮针肌肉注射为主及口服联合阴道用药为主两种黄体支持方案对取卵周期体外受精-胚胎移植(IVF-ET)妊娠结局的影响及其安全性观察。方法回顾性分析该中心2013年7月-2015年7月取卵周期IVF患者的临床资料,共491个周期,根据黄体支持给药方式不同进行分组。A组给予黄体酮针40 mg肌肉注射,地屈孕酮20 mg 2次/d口服。B组给予黄体酮胶囊200 mg 2次/d(晨起200 mg口服,睡前200 mg阴道用药),地屈孕酮20 mg 2次/d口服。比较两组妊娠结局的差异。结果两组影响妊娠结局的其他因素比较,差异均无统计学意义(P>0.05)。A、B两组的临床妊娠率分别为52.61%,59.80%,差异无统计学意义(P>0.05),但B组不良事件发生率较低。结论口服联合阴道上药的黄体支持方案与黄体酮针剂注射为主的黄体支持方案对新鲜周期胚胎移植妊娠结局的影响无差异,临床上可以以口服联合阴道上药的黄体支持方案代替针剂肌肉注射的黄体支持方案。
Objective To investigate the effect and safety of two kinds of luteal supportive programs, which mainly include intramuscular injection of progesterone and oral administration of vaginal drug, on pregnancy outcome of IVF-ET. Methods The clinical data of IVF patients from July 2013 to July 2015 in the center of the IVF were retrospectively analyzed. The total 491 cycles were divided into groups according to the different administration modes of luteal support. Group A was given 40 mg progesterone intramuscularly and dydrogesterone 20 mg twice daily. Group B was given progesterone capsules 200 mg 2 times / d (morning 200 mg oral, 200 mg before bedtime vaginal drug), dydrogesterone 20 mg 2 times / d orally. Differences in pregnancy outcome between the two groups were compared. Results There were no significant differences in other factors between the two groups (P> 0.05). The clinical pregnancy rates in groups A and B were 52.61% and 59.80%, respectively, with no significant difference (P> 0.05), but the incidence of adverse events in group B was lower. Conclusions There is no difference in luteal support regimen between oral combined vaginal drug administration and progesterone injection on pregnancy outcome of fresh-cycle embryo transfer. Clinically, corpus luteum can be used instead of intramuscular injection The luteal support program.