烯丙雌醇在人工授精周期中黄体支持的临床疗效观察

Clinical trial on the effectiveness of allylestrenol in luteinized support of intrauterine insemination cycle

目的比较黄体酮、烯丙雌醇两种黄体支持方法对促排卵与宫腔内人工授精妇女体内激素水平及其结果的影响,探讨烯丙雌醇应用于辅助生殖领域中的临床意义。方法2003-06-2004-09北京协和医院前瞻性分析54个促排卵与宫腔内人工授精周期的结果,患者经超声监测确定排卵日期,将排卵后的患者随机分为两组:烯丙雌醇组27例自排卵当日起服用烯丙雌醇进行黄体支持;黄体酮组27例,应用黄体酮进行黄体支持。所有患者于排卵后第0、3、6、9、12、15天取血进行人绒毛膜促性腺激素(HCG)、催乳激素(PRL)、雌二醇(E2)和孕酮(P)测定。结果两组妊娠率、流产率比较差异无统计学意义(P>0.05)。两组排卵后第0、3、6、9、12、15天血清HCG、PRL、E2差异无统计学意义,孕酮水平在排卵后第9天和第12天差异有统计学意义(P<0.05、P<0.01)。两组中的妊娠患者各检测点孕酮水平经比较差异无统计学意义(P>0.05)。两组继续妊娠患者,至妊娠3个月末,每周检测HCG、PRL、E2、P水平经比较差异均无统计学意义(P>0.05)。结论烯丙雌醇在辅助生育技术中进行黄体支持的临床疗效与黄体酮相似,作为口服制剂是辅助生育技术中进行黄体支持的一种较好选择。

Objective To compare the effectiveness of two luteinized support methods（ allylestrenol and progesterone ） in intrauterine insemination cycle. Methods A prospective, randomly controlled clinical trial was carried out from June. 2003 to Sep. 2004 in Peking Union Hospital. A total of 54 intrauterine insemination cycles were randomly divided into either allylestrenol group （ 27 cases） or progesterone group （ 27 cases）. Serum estradiol （ E2 ）, progestone （P） , human chorionic gonadotropine （HCG） and prolatin（PRL） levels were detected on day 0,3,6,9,12, 15 after ovulation. Results The pregnant rate and abortion rate were similar （ P 〉0.05 ）. There was no significant difference in serum HCG, PRL, E2 level on day 0,3,6,9,12,15 after ovulation（P 〉0.05）. There was significant difference in P level on day 9 and 12 between two groups （ P 〈 0.05 ）. Conclusion The effectiveness of allylestrenol in luteinized support of intrauterine insemination cycle is similar with progesterone. Allylestrenol is a good option＇of luteinized support in assisted reproductive technology.