Baruffi Ricardo, Mauri Ana Lucia, Petersen Claudia Guilhermino, Felipe Valéria, Franco José Gonçalves
Center for Human Reproduction, Sinhá Junqueira Maternity Foundation, Ribeirão Preto, Sãu Paulo, Brazil.
J Assist Reprod Genet. 2003 Dec;20(12):517-20. doi: 10.1023/b:jarg.0000013653.54830.2c.
Vaginal progesterone administration starting on the day of oocyte retrieval induced a decrease in uterine contraction frequency on the day of embryo transfer (ET) as compared with preovulatory values. Uterine relaxation before ET is likely to improve outcome by avoiding displacement of the embryo from the uterine cavity (Fanchin, Righini, de Ziegler, Oliviennes, Ledée, Frydman: Fertil Steril 2001;75:1136-1140). The objective of the present study was to determine whether the early use of vaginal progesterone on the day of oocyte retrieval may alter the embryo implantation and pregnancy rates.
A total of 103 patients were submitted for ovarian stimulation with GnRH-a and recombinant FSH (Puregon, Organon) for the application of invasive assisted reproduction techniques (ICSI). The patients were divided into two groups in a prospective and randomized manner: Group A (n = 51) where application of vaginal progesterone started (Utrogestan, Besins International) at the dose of 400 mg from the evening of the day of oocyte retrieval, and Group B (n = 52) started to apply vaginal progesterone at the same dose but from the evening of embryo transfer (2nd day).
The age of Group A patients (34.2 +/- 4.6) was similar (p = 0.50) to that of Group B patients (34.8 +/- 4.9). The number of oocytes retrieved and at metaphase II from Group A patients (10.6 +/- 6.9 and 7.8 +/- 6.0; respectively) did not differ significantly (p = 0.84 and p = 0.49, respectively) from the number of oocytes retrieved and metaphase II from Group B patients (10 +/- 5.6 and 6.7 +/- 4.7, respectively). Also, there was no difference (p = 0.48) in number of embryos transferred to Group A patients (2.7 +/- 0.8) versus Group B patients (2.7 +/- 0.9). Embryo implantation and pregnancy rates for Group A patients (12.6 and 27.4%, respectively) were equal (p = 0.98 and p = 1.0, respectively) to those for Group B patients (13.4 and 28.8%, respectively).
Vaginal progesterone at the dose of 400 mg started on the day of oocyte retrieval did not increase implantation or pregnancy rates when compared to the same dose started on the day of embryo transfer.
与排卵前值相比，在取卵日开始阴道给予孕酮可使胚胎移植（ET）日子宫收缩频率降低。ET前子宫松弛可能通过避免胚胎从子宫腔移位来改善结局（范钦，里基尼，德齐格勒，奥利维耶内斯，勒德，弗里德曼：《生育与不育》2001年；75：1136 - 1140）。本研究的目的是确定在取卵日早期使用阴道孕酮是否会改变胚胎着床率和妊娠率。
总共103例患者接受促性腺激素释放激素激动剂（GnRH - a）和重组促卵泡素（普利康，欧加农）刺激卵巢，以应用侵入性辅助生殖技术（卵胞浆内单精子注射）。患者被前瞻性随机分为两组：A组（n = 51），从取卵日当晚开始以400 mg的剂量应用阴道孕酮（安琪坦，贝西尼斯国际）；B组（n = 52）从胚胎移植日（第2天）当晚开始以相同剂量应用阴道孕酮。
A组患者年龄（34.2±4.6）与B组患者年龄（34.8±4.9）相似（p = 0.50）。A组患者获取的卵母细胞数量和处于中期II的卵母细胞数量（分别为10.6±6.9和7.8±6.0）与B组患者获取的卵母细胞数量和处于中期II的卵母细胞数量（分别为10±5.6和6.7±4.7）相比，差异无统计学意义（分别为p = 0.84和p = 0.49）。此外，A组患者移植的胚胎数量（2.7±0.8）与B组患者（2.7±0.9）相比，差异无统计学意义（p = 0.48）。A组患者的胚胎着床率和妊娠率（分别为12.6%和27.4%）与B组患者（分别为13.4%和28.8%）相等（分别为p = 0.98和p = 1.0）。
与在胚胎移植日开始使用相同剂量的阴道孕酮相比，在取卵日开始使用400 mg剂量的阴道孕酮不会提高着床率或妊娠率。
