口服黄体酮在黄体支持中的作用

Effect of oral progesterone on luteal support

目的:探讨口服黄体酮在黄体支持方面的作用。方法:采用随机分组病例对照研究,对10例非子宫性闭经患者除外妊娠后给予口服黄体酮胶丸治疗1周后诊刮并送病理。另将监测排卵指导受孕和IUI的患者120例随机分为4组,按黄体支持的不同方法设研究A、B、C 3组:A组给予肌注HCG,B组给予肌注黄体酮,C组给予口服黄体酮胶丸,设空白对照D组不予任何黄体支持。所有患者均在TVS监测排卵后开始黄体支持,在排卵后1周测定血E2和P水平。结果:①10例闭经患者在口服黄体酮胶丸1周后进行子宫内膜活检,有6例提示分泌期子宫内膜;②给予黄体支持的A、B、C 3组患者血P水平与对照D组比较差异均有显著性(P<0.05),而A、B、C 3组组间血P水平比较差异无显著性(P>0.05);4组患者血E2水平比较差异无显著性(P>0.05)。结论:①口服黄体酮可以将增殖期子宫内膜转变成分泌期子宫内膜,有明显的孕激素活性;②口服黄体酮用于黄体支持的效果与肌注HCG和黄体酮相似,可以作为一种常规的黄体支持方式;③口服黄体酮200 mg/d与肌注黄体酮20 mg/d生物效应相当。

Objective：To explore the effect of oral progesterone on luteal support. Methods：Randomization case control study was used. 10 cases of non - uterine amenorrhea after oral progesterone for one week underwent diagnostic curettage and pathological examination. 120 cases were divided into 4 groups, group A was given HCG intramuscular injection, group B was given progesterone intramuscular injection, group C was given oral progesterone capsule, group D was blank control group. The levels of estradiol and progesterone in serum after one week of ovulation were detected. Results：①10 non -uterine amenorrhea patients given diagnostic curettage and pathological examination after one week of oral progesterone, secretory endometrium were found in 6 cases. ②There was significant differuce in level of progesterone in serum between group A, B and C with group D （P 〈 0. 05 ） , but there was no difference in level of progesterone in serum between group A, B and C （ P 〉 0. 05 ） ; there was no difference in level of estradiol in serum between four groups （ P 〉 0. 05 ）. Conclusion： ①Oral progesterone can change proliferative endometrium into secretory endometrium, which acts as progesterone. ②Oral progesterone maybe used as a routine way of luteal support. ③Oral progesterone 200mg/d and intramuscular injection progesterone 20mg/d has the same biological effect.