雌激素不同用药方式在冻融胚胎移植中的应用

Administration of estrogen by different delivery routes in frozen-thawed embryo transfer

目的探讨雌激素不同给药方式在冻融胚胎移植中的应用。方法采用激素替代周期行冻融胚胎移植患者244例,随机分为经皮17β-雌二醇组120例(研究组)和口服戊酸雌二醇组124例(对照组)。观察两组患者血雌二醇浓度上升曲线、给予黄体酮日雌二醇用药总量、子宫内膜厚度和类型、周期取消率、胚胎移植结局及药物副作用。结果黄体日两组患者子宫内膜厚度差异无统计学意义(P=0.63);研究组雌二醇各监测点水平均高于对照组(P=0.04)、用药总量显著性较低(P=0.03);研究组周期取消率(0.83%)显著低于照组(6.45%)(P=0.02);研究组生化妊娠率和临床妊娠率高于对照组,自然流产率低于对照组,但差异无统计学意义(P值分别为0.90、0.54和0.16)。结论 17β-雌二醇经皮给药可以有效的应用于激素替代周期冻融胚胎移植患者。

Objective： To compare the influence of different delivery routes of estrogen therapy in the frozen thawed embryo transfer（FET）. Methods： A total of 244 patients underwent hormone replacement treatment for FET were divided to two groups：120 patients used 17beta-estrogen（Estradiol gel）by transdermal route in the transdermal group and 124 patients used oral route of estrogen（Estradiol valerate tablet,Progynova）in the oral group. Results： There was no statistical difference in the mean endometrial thickness（P=0.63）between the two groups. Comparing with oral group,the estradiol levels were significantly higher（P=0. 04）and drug consumption was significantly lower （P = 0. 03）in transdermal group. The period cancellation rate of the transdermal group was significantly lower （P = 0.02）. The biochemical pregnancy rate and clinical pregnancy rate were higher, abortion rate was lower in transdermal group, but there were no statistical difference（P = 0. 90,0. 54,0. 16 respectively）. Conclusions： The transdermal route is an effective method for the patients using hormone replace treatment in FET.