University Paris Diderot, Sorbonne Paris Cité, Paris, France; Department of Obstetrics and Gynecology, Robert-Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Department of Reproductive Medicine, University of Lille, Lille, France.
Reprod Biomed Online. 2019 Sep;39(3):446-451. doi: 10.1016/j.rbmo.2019.05.001. Epub 2019 May 8.
To determine whether adding intramuscular to vaginal administration of progesterone reduces miscarriage rates compared with those of vaginal administration alone for luteal phase support in women receiving oocyte donation and to determine the best time to introduce intramuscular progesterone.
Retrospective analysis of miscarriage rates in women receiving oocyte donation. Recipients underwent endometrial preparation by hormone replacement treatment. Vaginal progesterone alone or associated with intramuscular progesterone was used for luteal support.
This study analysed 186 oocyte donation cycles from January 2016 to May 2018 with embryo transfer on Day 2 or 3 and vaginal progesterone administration: 106 embryo transfer cycles with vaginal progesterone alone, 29 with weekly intramuscular progesterone added once the human chorionic gonadotrophin (HCG) assay was positive, and 51 with weekly intramuscular progesterone added the evening of embryo transfer. The rates of positive HCG assays, biochemical pregnancies and clinical pregnancies did not differ between the treatment groups. The miscarriage rate was significantly lower when intramuscular progesterone began the evening of embryo transfer than with vaginal administration alone (16.7% versus 47.0%, respectively; P = 0.049 after Bonferroni correction). The live birth rate was higher when intramuscular progesterone began the evening of embryo transfer than with vaginal administration alone (37.3% versus 16.0%, respectively; P = 0.009 after Bonferroni correction).
Adding intramuscular to vaginal progesterone administration appears to decrease the miscarriage rate and increase the live birth rate in oocyte donations. The initiation of intramuscular progesterone is most beneficial when it is introduced the evening of embryo transfer.
确定与单独阴道给予孕激素相比，在接受卵母细胞捐赠的妇女中，肌内给予孕激素是否可以降低流产率，并确定最佳的肌内给予孕激素时间。
对接受卵母细胞捐赠的妇女流产率的回顾性分析。接受者通过激素替代治疗进行子宫内膜准备。单独阴道给予孕激素或与肌内给予孕激素联合用于黄体支持。
这项研究分析了 2016 年 1 月至 2018 年 5 月期间的 186 个卵母细胞捐赠周期，胚胎移植于第 2 或 3 天进行，且阴道给予孕激素：106 个胚胎移植周期单独阴道给予孕激素，29 个胚胎移植周期在人绒毛膜促性腺激素（hCG）检测阳性时每周肌内给予孕激素 1 次，51 个胚胎移植周期在胚胎移植当晚每周肌内给予孕激素。各组之间 hCG 检测阳性、生化妊娠和临床妊娠率无差异。当肌内给予孕激素开始于胚胎移植当晚时，流产率显著低于单独阴道给予孕激素（分别为 16.7%和 47.0%；Bonferroni 校正后 P=0.049）。当肌内给予孕激素开始于胚胎移植当晚时，活产率高于单独阴道给予孕激素（分别为 37.3%和 16.0%；Bonferroni 校正后 P=0.009）。
在卵母细胞捐赠中，与单独阴道给予孕激素相比，肌内给予孕激素似乎可以降低流产率并提高活产率。当肌内给予孕激素在胚胎移植当晚引入时，效果最佳。
