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目的探讨口服地屈孕酮片在冻融胚胎移植(FET)周期中进行黄体支持对临床结局的影响。方法对2010年1月~2011年9月于我中心施行的1643例FET周期进行回顾性病例对照分析。患者按所采用的治疗方案不同进行分组:A组为自然周期FET,B组为激素替代周期(HRT)FET。A、B组又按黄体支持用药方案不同各分为两个亚组,其中A(Ⅰ)组使用地屈孕酮片(n=358例),A(Ⅱ)组使用黄体酮(n=634例);B(Ⅰ)组使用地屈孕酮片+补佳乐(n=185例),B(Ⅱ)组使用黄体酮+补佳乐(n=466例)。分别比较A、B两组中Ⅰ和Ⅱ方案对临床结局的影响。结果 1643个FET周期,在A、B两组中Ⅰ和Ⅱ两种黄体支持用药方案中,临床妊娠率、胚胎种植率、早期流产率、异位妊娠率、继续妊娠率均无统计学差异(P>0.05)。结论在FET周期中,应用口服地屈孕酮片进行黄体支持可达到与黄体酮针剂相同的临床结局,在FET的黄体支持中可用地屈孕酮片替代黄体酮针剂。
Objective To investigate the effect of oral administration of progesterone tablets on the outcome of luteal phase in frozen-thawed embryo transfer (FET) cycles. Methods A retrospective case-control analysis of 1643 FET cycles performed in our center from January 2010 to September 2011 was performed. Patients were grouped according to the treatment regimen adopted: Group A was a natural period FET, and Group B was a hormone replacement period (HRT) FET. Groups A and B were divided into two subgroups according to the different luteal supportive regimens. A (Ⅰ) group used dextromethorphan tablets (n = 358), and A (Ⅱ) patients received progesterone (n = 634) (N = 185). In group B (Ⅰ), progesterone + norepinephrine (n = 185) and progesterone + norepinephrine (n = 466) were used in group B (Ⅰ). The clinical outcomes were compared between the two groups A and B respectively. Results There were no significant differences in clinical pregnancy rate, embryo implantation rate, early miscarriage rate, ectopic pregnancy rate and continuing pregnancy rate among 1643 FET cycles in both groups Ⅰ and Ⅱ. P> 0.05). Conclusions During FET cycles, progesterone tablets administered orally to the corpus luteum support the same clinical outcome as progesterone injections, and progesterone tablets can be used in place of progesterone injections in the luteal support of FETs.