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阴道使用微粒化孕酮进行黄体支持。一项比较安琪坦®和雪诺酮®8%的随机研究。

Vaginal use of micronized progesterone for luteal support.A randomized study comparing Utrogestan® and Crinone® 8.

作者信息

Michnova Lucie, Dostal Jiri, Kudela Milan, Hamal Petr, Langova Katerina

机构信息

IVF Clinic Olomouc, Horni Lan 6, Olomouc, Czech Republic.

Department of Obstetrics and Gynecology, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic.

出版信息

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2017 Mar;161(1):86-91. doi: 10.5507/bp.2017.007. Epub 2017 Mar 14.

Abstract

BACKGROUND AND OBJECTIVE

Luteal phase physiology is distorted by in vitro fertilization (IVF) cycles using gonadotropin-releasing hormone (GnRH) agonists and antagonists, Controlled ovarian hyperstimulation leads to luteal phase defect and for this reason, luteal phase support is now an integral part of IVF/ICSI-ET programs. The support is provided by hCG, progesterone or GnRH-a. This study compared the efficiency, safety and tolerance of two vaginal micronized progesterones, Utrogestan and Crinone 8%.

METHODS

111 women, 18-40 years old, FSH < 10 IU/L and normal uterus findings were included. The efficiency of the two preparations to provide luteal support was evaluated by the fertilization, implantation, pregnancy and take-home baby rates. The safety was compared through the results of vaginal findings and vaginal inflammation markers before and after treatment. Comparison of tolerance was made by evaluating 21 subjective patient questionnaire parameters.

RESULTS

There were no significant differences between the preparations in terms of efficiency or safety though Crinone 8% was better tolerated.

CONCLUSION

The outcomes of this study suggest that a vaginal gel with micronized progesterone (Crinone 8%) is the optimal choice at this time for luteal support.

摘要

背景与目的

使用促性腺激素释放激素(GnRH)激动剂和拮抗剂的体外受精(IVF)周期会使黄体期生理功能紊乱。控制性卵巢过度刺激会导致黄体期缺陷,因此,黄体期支持现已成为IVF/卵胞浆内单精子注射-胚胎移植(ICSI-ET)方案的一个组成部分。这种支持由人绒毛膜促性腺激素(hCG)、孕酮或GnRH-a提供。本研究比较了两种阴道用微粒化孕酮(安琪坦和8%的雪诺酮)的有效性、安全性和耐受性。

方法

纳入111名年龄在18至40岁之间、促卵泡生成素(FSH)<10 IU/L且子宫检查结果正常的女性。通过受精率、着床率、妊娠率和活产率评估这两种制剂提供黄体支持的有效性。通过治疗前后阴道检查结果和阴道炎症标志物比较安全性。通过评估21项患者主观问卷参数比较耐受性。

结果

尽管8%的雪诺酮耐受性更好,但两种制剂在有效性或安全性方面无显著差异。

结论

本研究结果表明,含微粒化孕酮的阴道凝胶(8%的雪诺酮)目前是黄体支持的最佳选择。

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