Sofuoglu Kenan, Gun Ismet, Sahin Sadik, Ozden Okan, Tosun Oktay, Eroglu Mustafa
Kenan Sofuoglu, Department of Obstetrics and Gynecology, Zeynep Kamil Training and Education Hospital, Istanbul, Turkey.
Ismet Gun, GATA Haydarpaşa Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.
Pak J Med Sci. 2015 Mar-Apr;31(2):314-9. doi: 10.12669/pjms.312.6613.
To compare the outcomes of luteal phase support by micronized progesteron vaginal capsule 600mg/day and progesterone vaginal gel 180mg/day in the normoresponder IVF/ICSI-ET cycles of the patients down-regulated via GnRH agonist long protocol or fixed antagonist protocol below 40 years of age.
A total of 463 normoresponder cycles between January 2013 and December 2013 were retrospectively analyzed. Those with a BMI>28 kg/m(2), any kind of uterine, ovarian or adnexial pathology, any significant systemic, endocrine or metabolic disease or who were reported as azoospermia, were excluded from the study. The patients were grouped according to the usage of micronized progesterone vaginal capsule 600mg/day (Group 1) or progesterone vaginal gel 180mg/day (Group 2) as luteal phase support. Treatment cycle characteristics and pregnancy outcomes were compared between groups.
Group-I included 220 cycles and group 2 included 243 cycles. Although the MII oocyte percentage among the total number of MII oocytes was significantly higher in Group-II (77.5% and 80.2%; p=0.034), positive ß-hCG (32.3% and 21.8%; p=0.015) and clinical pregnancy (27.3% and 17.7%; p=0.018) rates were significantly higher in Group-I. No difference was observed between groups regarding the ongoing pregnancy rates (23.2% and 17.3%; p=0.143).
Micronized progesterone vaginal capsule 600mg daily used for luteal support in the IVF/ICSI-ET cycles was observed to significantly increase the biochemical and clinical pregnancy rates compared to progesterone vaginal gel 180mg daily. However, no difference was observed between two groups regarding ongoing pregnancy rates.
比较在年龄低于40岁、采用GnRH激动剂长方案或固定拮抗剂方案进行降调节的正常反应者体外受精/卵胞浆内单精子注射-胚胎移植（IVF/ICSI-ET）周期中，每日使用600mg微粒化黄体酮阴道胶囊与每日使用180mg黄体酮阴道凝胶进行黄体期支持的效果。
回顾性分析2013年1月至2013年12月期间共463个正常反应者周期。将体重指数（BMI）>28kg/m²、患有任何子宫、卵巢或附件病变、任何严重的全身、内分泌或代谢疾病或被报告为无精子症的患者排除在研究之外。根据黄体期支持时每日使用600mg微粒化黄体酮阴道胶囊（第1组）或每日使用180mg黄体酮阴道凝胶（第2组）对患者进行分组。比较两组的治疗周期特征和妊娠结局。
第1组包括220个周期，第2组包括243个周期。虽然第2组中成熟卵母细胞（MII）在总MII卵母细胞中的百分比显著更高（分别为77.5%和80.2%；p=0.034），但第1组的β-人绒毛膜促性腺激素（β-hCG）阳性率（分别为32.3%和21.8%；p=0.015）和临床妊娠率（分别为27.3%和17.7%；p=0.018）显著更高。两组之间的持续妊娠率无差异（分别为23.2%和17.3%；p=0.143）。
观察到在IVF/ICSI-ET周期中，每日使用600mg微粒化黄体酮阴道胶囊进行黄体支持比每日使用180mg黄体酮阴道凝胶能显著提高生化妊娠率和临床妊娠率。然而，两组之间的持续妊娠率无差异。
