地屈孕酮在冻融胚胎移植激素替代周期中的应用

Application of Dydrogesterone in the hormone replacement cycles for frozen-thawed embryo transfer

目的比较口服地屈孕酮与肌肉注射黄体酮应用于冻融胚胎移植(FET)激素替代黄体支持的临床效果。方法回顾性分析在本中心接受激素替代(HRT)内膜准备方案行FET治疗周期患者的临床资料。月经第3日起口服雌二醇片2mg,第14日超声监测。内膜≥8mm时,加用口服地屈孕酮60mg转化内膜(A组),或肌注油剂黄体酮80mg(B组),5d后解冻第5d胚胎。结果共完成689个FET激素替代周期,A、B两组临床妊娠率分别为42%、35%,种植率分别为27.3%、24.1%,流产率分别为20.1%、15.7%,组间比较差异均无统计学意义(P>0.05)。结论 FET激素替代周期中口服地屈孕酮简单方便,临床结果理想,可以替代肌肉注射油剂黄体酮。

Objective To compare the clinical effects of oral dydrogesterone and intramuscular progesterone in hormone replaced treatment of frozen-thawed embryo transfer（FET）. Methods The clinical data of patients in our center was taken for a retrospective analysis. Since the third day of menstruation , 2mg estradiol was administered orally. Ultrasound scan was per-formed at the fourteenth day of menstruation. When the thickness of endometrium was greater than 8mm , oral dydrogesterone 60mg （group A） or intramuscular progesterone 80mg （group B） was administered. All the fifth day embryos were thawed 5 days later. Results Totally 689 hormone replacement cycles were performed. The clinical pregnancy rates in the group A and group B were 42%and 35%, the implantation rates were 27.3%and 24.1%, and the abortion rates were 20.1%and 15.7%respective-ly. There was no significant difference in the two groups （P＆gt;0.05）. Conclusion The clinical result is perfect in oral dydro-gesterone in FET hormone replaced treatment, which suggests it can replace intramuscular progesterone completely in the treat-ments.