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口服地屈孕酮在冻融胚胎移植周期中的应用。

Oral dydrogesterone in frozen-thawed embryo transfer cycles.

机构信息

Irmandade da Santa Casa de Misericórdia de São Paulo, School of Medical Sciences, Department of Obstetrics and Gynecology - São Paulo (SP), Brazil.

Centro de Referência da Saúde da Mulher Hospital Pérola Byington, Human Reproduction - São Paulo (SP), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2022 Jan;68(1):100-105. doi: 10.1590/1806-9282.20210874.

DOI:10.1590/1806-9282.20210874
PMID:34909972
Abstract

OBJECTIVE

The aim of this study was to compare the use of micronized vaginal progesterone and oral dydrogesterone in the endometrial preparation for frozen-thawed embryo transfer.

METHODS

This was a randomized, controlled, open, two-armed clinical trial, with women undergoing frozen-thawed embryo transfer along with hormone replacement therapy for endometrial preparation, between September 2019 and February 2021. A total of 73 patients were randomly selected and orally administered 40 mg/day dydrogesterone (dydrogesterone group, n=36) or 800 mg/day micronized vaginal progesterone (micronized vaginal progesterone group, n=37), after endometrial preparation with transdermal estradiol. The main outcome was a viable ongoing pregnancy with 12 weeks of gestation as evaluated by ultrasound.

RESULTS

The reproductive outcomes in frozen-thawed embryo transfer cycles were similar, with pregnancy rates in the dydrogesterone and micronized vaginal progesterone treatment groups being, respectively, 33.3 and 32.4% at 12 weeks pregnancy (confidence interval= -22.4-20.6, p=0.196).

CONCLUSIONS

The use of oral dydrogesterone may be a more patient-friendly approach to endometrial preparation in frozen-thawed embryo transfer cycles, avoiding undesirable side effects and discomfort resulting from vaginal administration, while also providing similar reproductive results.

摘要

目的

本研究旨在比较米索前列醇阴道制剂和口服地屈孕酮在冻融胚胎移植中的子宫内膜准备中的应用。

方法

这是一项随机、对照、开放、双臂临床试验,于 2019 年 9 月至 2021 年 2 月期间,对接受冻融胚胎移植并进行激素替代治疗以进行子宫内膜准备的女性进行。共有 73 名患者被随机选择,每天口服 40mg 地屈孕酮(地屈孕酮组,n=36)或 800mg 米索前列醇阴道制剂(米索前列醇阴道制剂组,n=37),经皮雌激素子宫内膜准备后。主要结局是通过超声评估的 12 周妊娠的活胎持续妊娠。

结果

冻融胚胎移植周期的生殖结局相似,地屈孕酮和米索前列醇阴道制剂治疗组的妊娠率分别为 12 周妊娠时的 33.3%和 32.4%(置信区间= -22.4-20.6,p=0.196)。

结论

在冻融胚胎移植周期中,口服地屈孕酮可能是一种更适合患者的子宫内膜准备方法,可避免阴道给药引起的不良副作用和不适,同时提供相似的生殖结果。

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引用本文的文献

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Is oral dydrogesterone equivalent to vaginal micronized progesterone for luteal phase support in women receiving oocyte donation?对于接受卵母细胞捐赠的女性,口服地屈孕酮在黄体期支持方面是否等同于阴道微粒化孕酮?
Reprod Biol Endocrinol. 2024 Dec 5;22(1):154. doi: 10.1186/s12958-024-01322-7.
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Progesterone in Pregnancy: Evidence-Based Strategies to Reduce Miscarriage and Enhance Assisted Reproductive Technology.
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Med Sci Monit. 2024 Mar 8;30:e943400. doi: 10.12659/MSM.943400.
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The combination of dydrogesterone and micronized vaginal progesterone can render serum progesterone level measurements on the day of embryo transfer and rescue attempts unnecessary in an HRT FET cycle.地屈孕酮与微粒化阴道黄体酮联合应用可使 HRTFET 周期中胚胎移植日和挽救尝试时的血清孕激素水平检测变得不必要。
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