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目的:探讨新鲜胚胎移植周期黄体酮阴道缓释凝胶作为黄体支持的临床效果。方法:回顾性分析接受IVF/ICSI助孕的行新鲜胚胎移植患者的临床资料,统计分析3 193个周期采用黄体酮阴道缓释凝胶行黄体支持(A组)者的临床妊娠率和活产率,并与肌肉注射黄体酮行黄体支持的813个周期(B组)进行比较,同时进一步按长、短、拮抗剂方案进行分层分析。结果:活产率A组为34.3%,B组为34.9%,组间无统计学差异(P>0.05),临床妊娠率和流产率组间也均无统计学差异(P>0.05)。活产率分层分析显示,长方案A组为40.0%,B组为40.3%;短方案A组为25.9%,B组为28.3%,拮抗剂方案A组为28.3%,B组为28.8%,两两比较均无统计学差异(P>0.05),临床妊娠率和流产率也均无统计学差异(P>0.05)。结论:作为IVF/ICSI-ET周期的黄体支持,黄体酮阴道缓释凝胶临床效果与肌肉注射黄体酮相同,阴道凝胶给药是一种可行的替代肌肉注射的黄体支持方式。
Objective: To investigate the clinical effect of progesterone vaginal sustained-release gel in fresh embryo transfer as a corpus luteum support. Methods: The clinical data of fresh embryo transfer patients undergoing IVF / ICSI assisted pregnancy were retrospectively analyzed. The clinical pregnancy rates and live births of 3 193 cycles using progesterone vaginal sustained release gel in corpus luteum group (A group) were statistically analyzed. Rate and compared with 813 cycles (group B) of corpus luteumis supported by intramuscular injection of progesterone, and further stratified by long, short and antagonist programs. Results: The live birth rate was 34.3% in group A and 34.9% in group B, with no significant difference between the two groups (P> 0.05). There was also no significant difference in clinical pregnancy rate and abortion rate (P> 0.05). The live birth rate stratified analysis showed that 40.0% of patients in long-term group A and 40.3% of group B were 25.9% in short-term group A, 28.3% in group B, 28.3% in group A and 28.8% (P> 0.05). There was no significant difference in clinical pregnancy rate and miscarriage rate between the two groups (P> 0.05). CONCLUSIONS: As a corpus luteum supporter of IVF / ICSI-ET, progesterone vaginal sustained-release gel has the same clinical effect as intramuscular injection of progesterone. Vaginal gel administration is a viable luteal support alternative to intramuscular injection.