促排卵周期胚胎移植后黄体支持药物减量时间对妊娠结局的影响

Effect of duration of luteal support on pregnancy outcome after embryo transfer in induced ovulation cycles

目的 探讨IVF/ICSI-ET周期中黄体支持维持的时间对临床妊娠结局的影响。方法 回顾性分析2016年1~12月在兰州大学第一医院生殖医学专科医院行IVF/ICSI-ET助孕并获得临床妊娠的患者的临床资料,并根据黄体支持减药方案的不同分为2组:常规减药组(304例),在胚胎移植术后65~70d开始减药;早期减药组(296例),在移植后35~42d开始减药。比较两组患者的一般资料、早期胚胎停育率、孕中期流产率、早产率以及活产率等。结果 两组患者的一般资料比较无显著性差异(P>0.05)。早期减药组与常规减药组的获卵数、MⅡ卵率、2PN率、卵裂率、优质胚胎率比较均没有显著性差异(P>0.05);早期减药组与常规减药组的早期胚胎停育率(11.82%vs.12.17%)、孕中期流产率(3.04%vs.5.26%)、早产率(2.70%vs.3.95%)、活产率(82.43%vs.80.59%)比较亦没有显著性差异(P>0.05)。结论 IVF/ICSI助孕周期中,胚胎移植术后早期开始减少黄体酮用量对临床妊娠结局没有显著影响。

Objective : To explore the effects of maintenance time of luteal support on clinical pregnancy outcomes in IVF. Methods : The clinical data of patients who received IVF/ICSI-ET assisted pregnancy and obtained clinical pregnancy in the First Hospital of Lanzhou University from January to December 2016 were retrospectively analyzed. According to the different corpus luteum support reduction protocols,they were divided into two groups:the conventional drug reduction group( n =304),which started to reduce the drug 65-70 days after the embryo transfer;the early drug reduction group( n =296),which started to reduce the drug 35-42 days after the transplantation. The general data,early embryonic arrest rate,mid-pregnancy abortion rate,preterm birth rate,and live birth rate were compared between the two groups. Results : There was no significant difference in the general data between the two groups( P >0.05). There was no significant difference in the number of oocytes,MⅡ oocytes rate,2PN rate,cleavage rate and high quality embryo rate between the early drug reduction group and the conventional drug reduction group( P >0.05). Early embryonic arrest rate(11.82% vs. 12.17%),mid-pregnancy abortion rate(3.04% vs. 5.26%),the preterm birth rate(2.70% vs. 3.95%),and the live birth rate(82.43% vs. 80.59%) were not significantly different between the two groups( P >0.05). Conclusions : Early reduction of amount of progesterone after IVF-ET has no effect on clinical pregnancy outcome.