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在GnRH拮抗剂方案的卵胞浆内单精子注射(ICSI)周期中,雌二醇与孕酮联合黄体期支持与单纯孕酮黄体期支持的随机对照研究。

Luteal phase support with estradiol and progesterone versus progesterone alone in GnRH antagonist ICSI cycles: a randomized controlled study.

作者信息

Ismail Madkour Wael A, Noah Bassel, Abdel Hamid Amr M S, Zaheer Hena, Al-Bahr Awatif, Shaeer Mahmoud, Moawad Ashraf

机构信息

a Obstetrics and Gynecology Department , Ain-Shams University , Cairo , Egypt ;

b Dubai Gynecology and Fertility Centre , Dubai , UAE ;

出版信息

Hum Fertil (Camb). 2016 Jun;19(2):142-9. doi: 10.1080/14647273.2016.1200145.

Abstract

In vitro fertilization (IVF) cycles are associated with a defective luteal phase. Although progesterone supplementation to treat this problem is standard practice, estrogen addition is debatable. Our aim was to compare pregnancy outcomes in 220 patients undergoing antagonist intracytoplasmic sperm injection (ICSI) cycles protocol. The patients were randomly assigned into two equal groups to receive either vaginal progesterone alone (90 mg once daily) starting on the day of oocyte retrieval for up to 12 weeks if pregnancy occurred or estradiol addition (2 mg twice daily) starting on the same day and continuing up to seven weeks (foetal viability scan). Primary outcomes were pregnancy and ongoing pregnancy rates per embryo transfer. Secondary outcomes were implantation and early pregnancy loss rates. Pregnancy rates showed no significant difference between group 1 (39.09%) and 2 (43.63%) (p value = 0.3). Similarly, both groups were comparable regarding ongoing pregnancy rate (32.7% group 1 and 36.3% group 2, p value = 0.1). Implantation rates showed no difference between group 1 (19.25%) and group 2 (23.44%) (p value = 0.2). Early pregnancy loss rates were comparable, with 6.3% and 7.2% in groups 1 and 2, respectively, (p value = 0.4). In conclusion, the addition of 4 mg estrogen daily to progesterone for luteal support in antagonist ICSI cycles is not beneficial for pregnancy outcome.

摘要

体外受精(IVF)周期与黄体期缺陷有关。尽管补充孕酮来治疗这个问题是标准做法,但添加雌激素仍存在争议。我们的目的是比较220例接受拮抗剂方案卵胞浆内单精子注射(ICSI)周期的患者的妊娠结局。患者被随机分为两组,每组人数相等,一组从取卵日开始单独接受阴道孕酮(每日一次,90毫克),如果怀孕则持续12周;另一组从同一天开始添加雌二醇(每日两次,2毫克)并持续至7周(胎儿存活扫描)。主要结局是每次胚胎移植的妊娠率和持续妊娠率。次要结局是着床率和早期妊娠丢失率。第1组(39.09%)和第2组(43.63%)的妊娠率无显著差异(p值 = 0.3)。同样,两组在持续妊娠率方面具有可比性(第1组为32.7%,第2组为36.3%,p值 = 0.1)。第1组(19.25%)和第2组(23.44%)的着床率无差异(p值 = 0.2)。早期妊娠丢失率具有可比性,第1组和第2组分别为6.3%和7.2%(p值 = 0.4)。总之,在拮抗剂ICSI周期中,每日在孕酮基础上加用4毫克雌激素进行黄体支持对妊娠结局并无益处。

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