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经皮雌激素(雌二醇凝胶)用于冻融胚胎移植周期的子宫内膜准备:一项随机对照试验。

Trans dermal estrogen (oestrogel) for endometrial preparation in freeze embryo transfer cycle: An RCT.

作者信息

Shahrokh Tehraninejad Ensieh, Kabodmehri Roya, Hosein Rashidi Batol, Jafarabadi Mina, Keikha Fateme, Masomi Masomeh, Hagholahi Fedieh

机构信息

Health Reproductive Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Int J Reprod Biomed. 2018 Jan;16(1):51-56.

Abstract

BACKGROUND

Estrogen and progesterone are two crucial factors for endometrial preparation in frozen embryo transfer (FET) cycles. Studies assessing different forms of estradiol in FET have published already but literature lacks enough surveys on transdermal estrogen application in reproductive medicine.

OBJECTIVE

To investigate the effects of trans dermal estrogen (Oestrogel) on pregnancy rates in patients that candidate for FET cycle.

MATERIALS AND METHODS

In this randomized clinical trial, 100 women undergoing FET cycles referred to Imam Khomeeini Hospital were enrolled in two groups, randomly. Group I received 8 mg/day estradiol valerate (E2 tablet) orally and group II were treated with 6 mg/day transdermal oestrogel gel after suppression with gonadotropin releasing hormone agonist. In both groups medication were started in the first day of menstruation cycle and continued until endometrial thickness reached 8 mm. Pregnancy rates (chemical, clinical, and ongoing), abortion rate, live birth rate, and frequency of complications were compared between two groups.

RESULTS

Chemical and clinical pregnancy rates were not significantly different between two groups (p=0.384). The abortion rate was significantly lower in group II than group I (p=0.035). Ongoing pregnancy and the live birth rates were significantly higher in group II (p=0.035). The rate of complication was not different in two groups.

CONCLUSION

Oestrogel seems to enhance ongoing pregnancy and live birth rates in comparison to estradiol valerate tablet.

摘要

背景

雌激素和孕酮是冷冻胚胎移植(FET)周期中子宫内膜准备的两个关键因素。评估FET中不同形式雌二醇的研究已经发表,但生殖医学领域缺乏关于经皮应用雌激素的足够调查。

目的

研究经皮雌激素(欧适可凝胶)对接受FET周期患者妊娠率的影响。

材料与方法

在这项随机临床试验中,100名前往伊玛目霍梅尼医院接受FET周期的女性被随机分为两组。第一组口服8毫克/天戊酸雌二醇(E2片),第二组在使用促性腺激素释放激素激动剂抑制后,接受6毫克/天的经皮欧适可凝胶治疗。两组均在月经周期的第一天开始用药,持续至子宫内膜厚度达到8毫米。比较两组的妊娠率(生化妊娠、临床妊娠和持续妊娠)、流产率、活产率和并发症发生率。

结果

两组之间的生化妊娠率和临床妊娠率无显著差异(p = 0.384)。第二组的流产率显著低于第一组(p = 0.035)。第二组的持续妊娠率和活产率显著更高(p = 0.035)。两组的并发症发生率无差异。

结论

与戊酸雌二醇片相比,欧适可凝胶似乎能提高持续妊娠率和活产率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3499/5899770/368d74f9988b/ijrb-16-051-g001.jpg

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