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雌二醇给药持续时间与第3天玻璃化冷冻-解冻胚胎移植周期对妊娠结局影响的比较:一项随机对照试验。

Comparison of the duration of estradiol administration and the effect on pregnancy outcome of day 3 vitrified-warmed embryo transfer cycle: a randomized controlled trial.

作者信息

Zarei Afsoon, Keshavarzi Ameneh, Zare Maryam

机构信息

Infertility Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Obstetrics and Gynecology, School of Medicine, Shiraz University of Medical Science, Shiraz, Iran.

出版信息

Zygote. 2023 Oct;31(5):491-497. doi: 10.1017/S096719942300031X. Epub 2023 Jul 14.

DOI:10.1017/S096719942300031X
PMID:37448263
Abstract

Based on the fact that the follicular phase in the menstrual cycle has length variation, it has been assumed that the duration of oestrogen (E2) administration could also be variable; therefore, for the first time, this randomized clinical trial study was conducted to investigate and compare the duration of estradiol administration and the effect on pregnancy outcomes in the cleavage-stage frozen embryo transfer (FET) cycle. We included women aged 20-40 with a normal uterus on hysteroscopy between September and December 2022 and who were divided randomly into three groups: group A [ = 79; 8-11 days of oestrogen before progesterone (P4) supplementation], group B ( = 78; 12-14 days of oestrogen before P4 supplementation), and group C ( = 76; 15-18 days of estrogen before P4 supplementation). Serum levels for E2 on the initial progesterone day and P4 on the transfer day were measured. The effect of the duration of E2 administration on clinical pregnancy and pregnancy loss was investigated. We found no significant differences between the three groups in the clinical pregnancy rate ( = 0.696) and clinical abortion rate ( = 0.925) according to the duration of the E2. There was no significant difference in the E2, P4 levels, and endometrial thickness in pregnant vs. non-pregnant women. The mean of the E2 and P4 levels was 300.03 ± 22.21 and 25.36 ± 5.78, respectively. Our findings suggest that variation in the length of E2 administration (8-18 days) before progesterone initiation in day 3 FET cycles does not affect pregnancy outcome and transfer time can be flexibly arranged.

摘要

基于月经周期中卵泡期存在长度变化这一事实,人们认为雌激素(E2)给药的持续时间也可能存在差异;因此,首次开展了这项随机临床试验研究,以调查和比较在卵裂期冷冻胚胎移植(FET)周期中雌二醇给药的持续时间及其对妊娠结局的影响。我们纳入了2022年9月至12月间宫腔镜检查显示子宫正常的20 - 40岁女性,她们被随机分为三组:A组(n = 79;在补充孕酮(P4)前给予8 - 11天雌激素)、B组(n = 78;在补充P4前给予12 - 14天雌激素)和C组(n = 76;在补充P4前给予15 - 18天雌激素)。测量了初始孕酮日的E2血清水平和移植日的P4血清水平。研究了E2给药持续时间对临床妊娠和妊娠丢失的影响。根据E2的持续时间,我们发现三组在临床妊娠率(P = 0.696)和临床流产率(P = 0.925)方面无显著差异。妊娠女性与未妊娠女性在E2、P4水平及子宫内膜厚度方面无显著差异。E2和P4水平的平均值分别为300.03±22.21和25.36±5.78。我们的研究结果表明,在第3天FET周期中开始补充孕酮前E2给药长度(8 - 18天)的变化不影响妊娠结局,移植时间可以灵活安排。

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