国际生殖健康/计划生育杂志

国际生殖健康/计划生育 ›› 2017, Vol. 36 ›› Issue (4): 280-282.

• 论著 • 上一篇    下一篇

不同黄体支持方案在人绒毛膜促性腺激素诱发排卵自然周期冻融胚胎移植中的临床结局分析

王力，周雪源，闻姬，崔薇   

  1. 250001  济南，山东中医药大学第二附属医院生殖中心（王力，闻姬，崔薇）；山东中医药大学（周雪源）
  • 收稿日期:2017-04-18 修回日期:2017-05-24 出版日期:2017-07-15 发布日期:2017-07-15

Clinical Outcome Analysis of Different Luteal Support Protocols in the Frozen-thawed Embryo Transfer of Natural Cycle after hCG Administration

WANG Li，ZHOU Xue-yuan，WEN Ji，CUI Wei   

  1. Department of Reproductive Medicine，The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine，Jinan 250001，China（WANG Li，WEN Ji，CUI Wei）；Shandong University of Chinese Medicine，Jinan 250014，China（ZHOU Xue-yuan）
  • Received:2017-04-18 Revised:2017-05-24 Published:2017-07-15 Online:2017-07-15

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摘要： 目的：分析不同黄体支持方案在人绒毛膜促性腺激素（hCG）诱发排卵自然周期（NC）方案冻融胚胎移植（FET）过程中的不同临床结局。方法：选择2015年1月—2016年1月采用hCG诱发排卵NC方案FET的35岁以下患者，随机分组，最终入组286例。根据黄体支持方案分为：Ⅰ组（n=81）无黄体支持；Ⅱ组（n=104）口服地屈孕酮20 mg，2次/d；Ⅲ组（n=101）肌内注射黄体酮20 mg/d，同时口服地屈孕酮10 mg，2次/d。比较3组患者一般资料、临床特征、治疗结局。结果：3组患者年龄、不孕年限、不孕类型、不孕原因、基础卵泡刺激素（FSH）水平，体质量指数（BMI）比较差异均无统计学意义（均P＞0.05）。3组患者的控制性超促排卵方案、受精方式、新鲜周期治疗结局、hCG日激素水平和移植日子宫内膜厚度比较差异均无统计学意义（均P＞0.05）。3组患者的移植胚胎数、胚胎种植率、临床妊娠率、异位妊娠率、继续妊娠率比较差异均无统计学意义（均P＞0.05）。结论：对于年轻患者hCG诱发排卵自然周期冻融胚胎移植，不进行黄体支持是可行的。但是临床中需要与患者进行深入的沟通交流。对于有顾虑的患者，口服地屈孕酮方案满意度高、用药方便，可以选择应用。

关键词: 胚胎移植, 受精, 体外, 绒毛膜促性腺激素, β亚单位, 人, 黄体, 冻融胚胎移植, 黄体支持

Abstract: Objective：To analyze the clinical outcomes of different luteal support protocols in natural cycle frozen-thawed embryo transfer after hCG administration. Methods：A total of 286 patients aged ＜35 years undergoing the natural cycles and hCG induced ovulation, from January 2015 to January 2016, were randomly divided into three groups: the patients with no luteal support as the groupⅠ (n=81), the patients who received oral dydrogesterone as the groupⅡ (n=104), and the patients who received a combination of intramuscular progesterone and oral dydrogesterone as the group Ⅲ (n=101). The general data and clinical outcomes were compared among three groups. Results：There were no significant differences in the age, duration of infertility, types of infertility, causes of infertility, basic FSH level and BMI among the three groups (P＞0.05). There were no significant differences in the control ovarian hyperstimulation protocol, fertilization procedure, treatment outcomes of fresh cycle, hormone levels on the hCG day and endometrial thickness on the transfer day among the three groups (P＞0.05). Interestingly, there were no significant differences in the embryo recovery rate, implantation rate, clinical pregnancy rate, early abortion rate, ectopic pregnancy rate and continued pregnancy rate among the three groups (P＞0.05). Conclusions：It is feasible that there is no luteal support for those young patients undergoing hCG administration natural cycles, with a good communication. As for those patients who still have concerns, the protocol of oral dydrogesterone, with its convenience and curative effect, is advisable.

Key words: Embryo transfer, Fertilization in vitro, Chorionic gonadotropin, beta subunit, human, Corpus luteum, Frozen-thawed embryo transfer, Luteal support