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两种不同肌内注射黄体酮制剂在接受冻融胚胎移植周期的女性中的结局比较分析。

A Comparative Analysis of Outcomes Between Two Different Intramuscular Progesterone Preparations in Women Undergoing Frozen Embryo Transfer Cycles.

作者信息

Seshadri Srividya, Odia Rabi, Ozturk Ozkan, Saab Wiam, AlChami Ali, Gonzalez Xavier Viñals, Salim Saba, Saab Wael, Serha Paul

机构信息

The Centre for Reproductive and Genetic Health, London, UK.

Gilbert and Rose-Marie Chagoury Health Sciences Center, The Lebanese American University, Beirut, Lebanon.

出版信息

J Reprod Infertil. 2022 Jan-Mar;23(1):46-53. doi: 10.18502/jri.v23i1.8452.

Abstract

BACKGROUND

The purpose of the current study was to assess if luteal support with intramuscular (IM) 17 alpha-hydroxyprogesterone caproate (17-OHPC) (Lentogest, IBSA, Italy) improves the pregnancy outcome in comparison to natural intramuscular progesterone (Prontogest, AMSA, Italy) when administered to recipients in a frozen embryo transfer cycle.

METHODS

A retrospective comparative study was performed to evaluate outcomes between two different intramuscular regimens used for luteal support in frozen embryo transfer cycles in patients underwent autologous in vitro fertilization (IVF) cycles (896 IVF cycles) and intracytoplasmic sperm injection (ICSI) who had a blastocyst transfer from February 2014 to March 2017 at the Centre for Reproductive and Genetic Health (CRGH) in London.

RESULTS

The live birth rates were significantly lower for the IM natural progesterone group when compared to 17-OHPC group (41.8% . 50.9%, adjusted OR of 0.63 (0.31-0.91)). The miscarriage rates were significantly lower in the 17-OHPC group compared to the IM natural progesterone group (14.5% . 19.2%, OR of 1.5, 95% CI of 1.13-2.11). The gestational age at birth and birth weight were similar in both groups (p=0.297 and p=0.966, respectively).

CONCLUSION

It is known that both intramuscular and vaginal progesterone preparations are the standard of care for luteal phase support in women having frozen embryo transfer cycles. However, there is no clear scientific consensus regarding the optimal luteal support. In this study, it was revealed that live birth rates are significantly higher in women who received artificial progesterone compared to women who received natural progesterone in frozen embryo transfer cycles.

摘要

背景

本研究的目的是评估在冷冻胚胎移植周期中,给接受者肌肉注射己酸17α-羟孕酮(17-OHPC,商品名Lentogest,意大利IBSA公司生产)进行黄体支持,与注射天然肌肉注射用黄体酮(商品名Prontogest,意大利AMSA公司生产)相比,是否能改善妊娠结局。

方法

进行了一项回顾性比较研究,以评估在2014年2月至2017年3月期间于伦敦生殖与遗传健康中心(CRGH)接受自体体外受精(IVF)周期(896个IVF周期)及卵胞浆内单精子注射(ICSI)并进行囊胚移植的患者中,两种不同的用于冷冻胚胎移植周期黄体支持的肌肉注射方案的结局。

结果

与17-OHPC组相比,肌肉注射天然黄体酮组的活产率显著较低(41.8%对50.9%,校正比值比为0.63(0.31 - 0.91))。与肌肉注射天然黄体酮组相比,17-OHPC组的流产率显著较低(14.5%对19.2%,比值比为1.5,95%置信区间为1.13 - 2.11)。两组的出生孕周和出生体重相似(分别为p = 0.297和p = 0.966)。

结论

已知肌肉注射和阴道用黄体酮制剂都是进行冷冻胚胎移植周期的女性黄体期支持的标准治疗方法。然而,关于最佳黄体支持尚无明确的科学共识。在本研究中,发现在冷冻胚胎移植周期中,接受人工合成黄体酮的女性的活产率显著高于接受天然黄体酮的女性。

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Luteal phase support for assisted reproduction cycles.辅助生殖周期的黄体期支持。
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本文引用的文献

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Freeze-all policy: fresh vs. frozen-thawed embryo transfer.冻融胚胎移植:鲜胚与冻胚。
Fertil Steril. 2015 May;103(5):1190-3. doi: 10.1016/j.fertnstert.2015.01.045. Epub 2015 Mar 4.

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