| 摘要: |
| 摘要 目的：探讨不同黄体酮给药方案对冻融胚胎移植（FET）患者子宫内膜容受性、妊娠结局的影响，并比较其治疗成本。方法：进行回顾性研究，选取2020年8月至2022年7月于我院生殖中心进行胚胎植入前遗传学检测（PGT）-FET的376例不孕患者为研究对象，收集其临床资料，根据患者采用的黄体酮给药方案将其分为两组：A组（n=182，黄体酮胶囊口服）、B组（n=194，黄体酮软胶囊阴道上药），对比两组子宫内膜容受性指标[包括子宫内膜厚度和子宫动脉血流动力学参数[阻力指数（RI）、搏动指数（PI）和收缩期峰值/舒张末期流速（S/D）]、妊娠结局及治疗成本。结果：两组年龄、体质指数（BMI）、基础卵泡刺激素（bFSH）、基础黄体生成素（bLH）、基础雌二醇（bE2）、基础孕酮（bP）比较差异均不显著（P>0.05）。两组HCG日LH、HCG日E2、HCG日P、获卵数、MⅡ卵子数、移植日内膜厚度、移植囊胚数及移植优质囊胚率比较差异均不显著（P>0.05）。两组HCG日和移植日子宫内膜厚度及子宫动脉S/D、RI、PI比较差异均不显著（P>0.05）。两组生化妊娠率、临床妊娠率、早期流产率及继续妊娠率比较差异均不显著（P>0.05）。 A组阴道早期出血率和晚期出血率均低于B组（P<0.05）。A组成本-效果比为6.78，低于B组的8.56（P<0.05）。结论：PGT-FET患者采用黄体酮胶囊口服治疗与黄体酮软胶囊阴道上药治疗所获临床效果及对子宫内膜容受性的保护作用较为接近，但前者可以减小阴道出血和治疗成本。 |
| 关键词: 冻融胚胎移植 胚胎植入前遗传学检测 黄体支持 黄体酮 妊娠结局 |
| DOI： |
| 分类号: |
| 基金项目:十堰市市级引导性科研项目；编号:21Y94 |
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| He Chenhui, Wang Silu, Lei Yue, Zhao Lei*Reproductive Medicine Center, Taihe Hospital, Shiyan City, Hubei Province 442000 |
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何晨晖
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Reproductive Medicine Center, Taihe Hospital
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| Abstract: |
| Abstract Objective: To investigate the effects of different progesterone administration regimens on endometrial susceptibility and pregnancy outcomes in patients with freeze-thaw embryo transfer (FET), and to compare the treatment costs. Methods: A retrospective study was conducted. 376 infertile patients who underwent preimplantation genetic testing (PGT) -FET in the reproductive Center of our hospital from August 2020 to July 2022 were selected as the research objects, and their clinical data were collected. The patients were divided into two groups according to the progesterone administration regimen: Group A (n=182, oral progesterone capsules), group B (n=194, vaginal administration of progesterone softgel capsules), Endometrial receptivity indexes (including endometrial thickness and uterine arterial hemodynamics parameters (resistance index (RI), pulsation index (PI) and peak systolic/end-diastolic flow rate (S/D)), pregnancy outcomes and treatment costs were compared between the two groups. There were no significant differences in age, body mass index (BMI), basal follicle stimulating hormone (bFSH), basal luteinizing hormone (bLH), basal estradiol (bE2) and basal progesterone (bP) between the two groups (P>0.05). There were no significant differences between the two groups on HCG day LH, HCG day E2, HCG day P, number of eggs harvested, number of MⅡ eggs, endometrial thickness on transplantation day, number of transplanted blastocysts and rate of transplanted high-quality blastocysts (P>0.05), while there were no significant differences between the two groups on HCG day and transplantation day as well as uterine artery S/D, RI and PI (P>0.05). There were no significant differences in the biochemical pregnancy rate, clinical pregnancy rate, early abortion rate and continued pregnancy rate between the two groups (P>0.05). The rate of early vaginal bleeding and late vaginal bleeding in group A was lower than that in group B (P<0.05). The ratio of prim-effect in group A was 6.78, which was lower than that in group B (8.56, P<0.05). Conclusion The clinical effect and protective effect of oral progesterone capsule on endometrial receptivity of PGT-FET patients are similar to that of progesterone softgel capsule, but the former can reduce vaginal bleeding and treatment cost. |
| Key words: freeze-thaw embryo transfer Preimplantation genetic testing Luteal support Progesterone Pregnancy outcome |
