Ying Luke Y, Hurst Bradley S, Matthews Michelle, Usadi Rebecca, Coddington Charles C, Eskew Ashley M, Ying Ying
Women's Care Florida, Safety Harbor, Florida, USA.
Department of Obstetrics and Gynecology, Carolinas Medical Center, Atrium Health, Charlotte, North Carolina, USA.
Reprod Sci. 2025 Jan;32(1):85-90. doi: 10.1007/s43032-024-01600-0. Epub 2024 Jun 4.
This study aimed to determine whether the use of vaginal Endometrin plus intramuscular progesterone on every third day (VIM) in programmed frozen embryo transfer (FET) is associated with lower pregnancy and live birth rates compared to daily intramuscular progesterone (IM). FET data from a single program were collected between November 2018 and December 2021. A total of 903 FETs were analyzed, including 504 FETs in the IM group, and 399 FETs in the VIM group. Inclusion criteria were women undergoing FETs with either 50 mg daily IM progesterone only (control) or 200 mg Endometrin twice daily plus 50 mg IM progesterone on every third day, with the transfer of a single day 5 or 6 frozen embryo. There were no significant differences in patient age at time of FETs, BMI, endometrial thickness, blastocyst quality, or infertility diagnosis between the groups. The VIM had significantly lower positive hCG and clinical pregnancy rates compared to the IM (60.2% vs 72.0% and 40.6% vs 56.7%, respectively, P = 0.0002 and P < 0.0001). The live birth rate was 36.1% in the VIM, compared to 49.4% in the IM (P < 0.0001). These findings also remained significant when excluding FETs with donor egg (35.9% vs 50.1%, P < 0.0001). This study demonstrated that VIM in FET cycles yields significantly lower pregnancy and live birth rates compared to IM along. IM progesterone alone may be preferable to combined Endometrin and IM progesterone in patients undergoing programmed frozen embryo transfers.
本研究旨在确定在计划性冷冻胚胎移植（FET）中，每隔三天使用阴道用安琪坦加肌肉注射黄体酮（VIM）与每日肌肉注射黄体酮（IM）相比，是否会导致更低的妊娠率和活产率。收集了2018年11月至2021年12月期间来自单个机构的FET数据。共分析了903例FET，其中IM组504例，VIM组399例。纳入标准为接受FET的女性，她们要么仅每天肌肉注射50mg黄体酮（对照组），要么每天两次使用200mg安琪坦加每隔三天肌肉注射50mg黄体酮，并移植单个第5天或第6天的冷冻胚胎。两组之间在FET时的患者年龄、BMI、子宫内膜厚度、囊胚质量或不孕诊断方面没有显著差异。与IM组相比，VIM组的hCG阳性率和临床妊娠率显著更低（分别为60.2%对72.0%和40.6%对56.7%，P = 0.0002和P < 0.0001）。VIM组的活产率为36.1%，而IM组为49.4%（P < 0.0001）。在排除供体卵FET后，这些结果仍然显著（35.9%对50.1%，P < 0.0001）。本研究表明，在FET周期中，与单独使用IM相比，VIM产生的妊娠率和活产率显著更低。对于接受计划性冷冻胚胎移植的患者，单独使用肌肉注射黄体酮可能比联合使用安琪坦和肌肉注射黄体酮更可取。
