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目的比较激素替代周期及自然周期冻融胚胎移植(FET)后应用不同剂型黄体酮行黄体支持对妊娠结局的影响,研究黄体酮阴道缓释凝胶(雪诺同)的临床应用价值。方法回顾性分析2013年1月-2014年12月该中心252个激素替代周期FET及295个自然周期FET,根据不同的黄体支持方案,将患者分为肌注黄体酮+口服地屈孕酮组(A组);肌注黄体酮+雪诺同组(B组)。比较两组的临床妊娠率、持续妊娠率和胚胎种植率等指标。结果在激素替代FET中,B组生化妊娠率(66.67%)、临床妊娠率(58.33%)均高于A组生化妊娠率(55.22%)、临床妊娠率(41.11%),差异均有统计学意义(均P<0.05);在自然周期FET中,两组的生化妊娠率、临床妊娠率、胚胎种植率比较,差异均无统计学意义(均P>0.05)。结论黄体酮阴道缓释凝胶应用于无内源性黄体生成的激素替代FET中,可以提高临床妊娠率。
Objective To compare the effect of different forms of progesterone on pregnancy outcomes after hormone replacement cycles and natural cycles of frozen-thawed embryo transfer (FET), and to investigate the clinical value of progesterone vaginal sustained-release gel. Methods From January 2013 to December 2014, 252 hormone replacement cycle FETs and 295 natural cycle FETs were retrospectively analyzed. According to different luteal support protocols, patients were divided into intramuscular injection of progesterone + oral dydrogesterone (Group A), intramuscular injection of progesterone plus sirolimus (group B). The clinical pregnancy rate, continuous pregnancy rate and embryo implantation rate were compared between the two groups. Results In hormone replacement FET, the biochemical pregnancy rate (66.67%) and clinical pregnancy rate (58.33%) in group B were higher than those in group A (55.22%) and clinical pregnancy rate (41.11%), the difference was statistically significant (P <0.05). There was no significant difference in biochemical pregnancy rate, clinical pregnancy rate and embryo implantation rate among the two groups (P> 0.05). Conclusions Progesterone vaginal sustained-release gel can be used in hormonal replacement FETs without endogenous luteinization to improve the clinical pregnancy rate.