IVF/ICSI术后用黄体酮阴道缓释凝胶作黄体支持的临床情况分析

目的：探讨阴道放置黄体酮阴道缓释凝胶（商品名：雪诺同8%）在体外受精（IVF）和卵细胞浆内单精子注射（ICSI）术后黄体支持的临床疗效。方法回顾性分析了进行体外受精-胚胎移植（IVF-ET）138个新鲜周期的患者临床资料，按不同黄体支持方法分两组：黄体酮肌内注射组（A组）60例，阴道放置雪诺同8%（B组）78例。观察两组的着床率、临床妊娠率、早期流产率以及药物不良反应发生率。结果138个新鲜周期中，术后随访期间妊娠共81例，总临床妊娠率为58.7%（81/138）， B组的临床妊娠率高于A组的临床妊娠率，差异有统计学意义（P〈0.05）， B组的不良反应率明显低于A组的不良反应率，差异有统计学意义（P〈0.05）。B组的着床率、早期流产率与A组比较，差异均无统计学意义（P〉0.05）。结论阴道放置雪诺酮8%在IVF-ET术后进行黄体支持是有效的黄体支持方案，可提高临床妊娠率，且使用简便，可避免患者由于注射黄体酮产生的不良反应。

Analysis of clinical information of progesterone sustained-released vaginal gel as luteal phase support in in-vitro fertilization and intracytoplamsic sperm injection cycles

Objective To investigate the therapeutic effect of progesterone sustained-released vaginal gel（ Crinone8%） as luteal phase support in in-vitro fertilization（IVF） and intracytoplamsic sperm injection（ ICSI） cycles. Methods Clinical data of 138 cycles were analyzed retrospectively. They were divided into two groups according different luteal support randomly. Group A：60 cases, with progesterone as luteal support. Group B：78 cases, with Crinone 8% Gel as luteal support.Implantation rate, clinical pregnancy rate, miscarriage rate and adverse drug reaction rate were observed. Results All of the 138 cases, 81 became pregnant within the follow up. The total clinical pregnancy rates were 58.7%（81/138）. The pregnancy rates of group B were significantly higher than group A. The adverse drug reaction rate of group B was lower than group A, its’differences had statistic significance（P〈0.05）. There were no statistical differences between the 2 groups in implantation rate and miscarriage rate（P〉0.05）. Conclusion It is an effective program with vaginal administration of Crinone 8%gel as luteal support in in-vitro fertilization-embryo transfert. It can improve clinical pregnancy rate. Furthermore, it can avoid adverse drug reaction from the injection of progesterone and use conveniently.