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1.
The use of progesterone for luteal phase support has been demonstrated to be beneficial in assisted reproduction cycles using gonadotrophin-releasing hormone analogues (GnRHa). Two micronized progesterone preparations are available for vaginal administration: capsules and gel. The objective of this study was to compare the efficacy of these two forms for luteal phase support in assisted reproduction cycles. A total of 244 couples undergoing IVF/intracytoplasmic sperm injection cycles were included in the study and were randomly allocated (sealed envelopes) into two groups: group 1 (122) received vaginal capsules of 200 mg of micronized progesterone (Utrogestan), 3 times daily, and group 2 (122) received micronized progesterone in gel (Crinone 8%), once daily. Both groups received progesterone for 13 days beginning day 1 after oocyte retrieval, continuing until the pregnancy test was performed and until 12 weeks of pregnancy. Groups were compared by clinical data and assisted reproduction results and had similar ages and causes of infertility. Although the pregnancy rate was higher for those receiving progesterone gel than capsules (44.26 and 36.06% respectively), this difference was not statistically significant. The study showed that vaginal progesterone gel and capsules used for luteal phase support in assisted reproduction cycles with long protocol GnRHa result in similar pregnancy rates. 相似文献
2.
Mesut Oktem Setenay Arzu Yilmaz Nuray Bozkurt Mehmet Erdem Ahmet Erdem 《Gynecological endocrinology》2014,30(12):909-912
Objective: This study aimed to evaluate the effect of luteal phase support on clinical pregnancy and live birth rates after ovulation induction and intrauterine insemination (IUI).Methods: 579 cycles from 2010 to 2013 were retrospectively evaluated. Ovarian stimulation was performed with gonadotropins, and rHCG was used for ovulation triggering. All patients received IUI. 451 cycles were supported by receiving vaginal micronized progesterone capsules (142 cycles) or vaginal progesterone gel (309 cycles) whereas 128 cycles were not supported.Results: Clinical pregnancy (20.6 versus 9.4%; p?=?0.004) and live birth rates (14 versus 7%; p?=?0.036) were higher for supported group than for unsupported group. Progesterone gel and micronized progesterone subgroups achieved similar clinical pregnancy and live birth rates (21.4 versus 19%, p?=?0.567 and 14.2 versus 13.4%, p?=?0.807; respectively).Conclusions: Luteal phase support improved the success of IUI cycles affecting both clinical pregnancy and live birth rates when gonadotropins were used for ovulation induction. The use of vaginal progesterone gel or micronized progesterone significantly improves clinical pregnancy rates. The live birth rates were higher in the progesterone gel group, but were similar in the micronized progesterone group compared to the unsupported group. 相似文献
3.
《Gynecological endocrinology》2013,29(12):1010-1013
The aim of the present study was to compare the efficacy and satisfaction rate of combined therapy of oral micronized progesterone capsules and vaginal progesterone gel versus monotherapy with vaginal progesterone gel in luteal support. A case–control study was performed on a total number of 370 women aged?<45 years undergoing IVF-ET treatment. The patients received either combination of Crinone 8% vaginal gel, 90?mg daily dose and Utrogestan oral capsules 3×100?mg, or Crinone 8% vaginal gel, 90?mg daily. Progesterone supplementation begun on the day of oocyte retrieval and continued until pregnancy was tested and in the case of pregnancy until week 8. The comparable rates of ongoing pregnancies were noted with use of combined-progesterone therapy (39.5%) and progesterone-monotherapy (33.5%). Abortion rate (6.4% vs. 15.6%) was significantly lower with the use of combined therapy. Tolerability and satisfaction of both supplements was almost equal but bleeding occurred more frequently in the progesterone-monotherapy group. In conclusion, the efficacy, satisfaction and tolerability of combined and vaginal progesterone supplements were comparable, but bleeding in early pregnancy and abortion rate presented more frequently with the use of vaginal progesterone. 相似文献
4.
The purpose of this study was to review the rationale for vaginal progesterone treatment as luteal support in IVF, and the clinical experience with vaginal micronized progesterone gel. It was found that luteal support with exogenous progesterone significantly improves implantation and pregnancy rates after IVF. Vaginal administration offers a number of potential advantages over intramuscular injection in terms of tolerability and convenience. The clinical experience with Crinone 8%, a vaginal gel containing 90 mg micronized progesterone in a polycarbophil base, indicates that the use of this preparation is associated with pregnancy rates comparable with those achieved after intramuscular administration of progesterone. Moreover, in studies in which patient preferences have been assessed, significantly higher preferences for vaginal micronized progesterone gel have been reported, compared with intramuscular administration or vaginal suppositories. In conclusion, the vaginal micronized progesterone gel used in this study provided effective and well-tolerated luteal support in women undergoing IVF. 相似文献
5.
Progesterone administration in patients with absent ovaries 总被引:6,自引:0,他引:6
P Devroey G Palermo C Bourgain L Van Waesberghe J Smitz A C Van Steirteghem 《International journal of fertility》1989,34(3):188-193
Forty-four women with absent ovaries who were referred to our centre for oocyte donation were treated with oestradiol valerate and natural progesterone. Serum concentrations and endometrial changes were evaluated on day 21 of stimulated luteal phases after the daily administration of 100 mg of natural progesterone in oil injected intramuscularly or after the ingestion of 300 mg of micronized progesterone or after vaginal administration of 300 mg or 600 mg micronized progesterone, respectively. Endometrial tissue did not show evidence of an adequate secretory pattern after orally administered progesterone. However, after intramuscular injection of 100 mg of natural progesterone and after the vaginal administration of 300 to 600 mg of micronized progesterone, the histologic and electron microscopic pictures were similar in all treatment groups and were close to the expected day 21 of the cycle. Serum levels of progesterone after intramuscular injection were five times higher than after vaginal administration. 相似文献
6.
I. Hatoum L. Bellon N. Swierkowski M. Ouazana S. Bouba K. Fathallah B. Paillusson M. Bailly F. Boitrelle L. Alter M. Bergère J. Selva R. Wainer 《Journal of assisted reproduction and genetics》2018,35(3):425-429
Purpose
The purpose of this study was to determine the effect of stimulated and artificial endometrial preparation protocols on reproductive outcomes in frozen embryo transfer (FET) cycles.Methods
We performed a retrospective study of 1926 FET cycles over a 3.5-year period in the Fertility Unit at a University Hospital. Stimulated and artificial protocols were used for endometrial preparation. The embryos for FET were obtained from either in vitro fertilization or intracytoplasmic sperm injection cycles. Live birth rate and early pregnancy loss rates were retrospectively compared.In artificial protocols, oral or vaginal administration of oestradiol 2 mg two or three times a day was followed by vaginal supplementation with progesterone 200 mg two or three times a day. In stimulated protocols, recombinant follicle-stimulating hormone was administered from day 4 onward. Vaginal ultrasound was used for endometrial and ovarian monitoring. A pregnancy test was performed 14 days after FET. If it was positive, oestradiol and progesterone were administered up until the 12th week of gestation in artificial cycles. We defined early pregnancy losses as biochemical pregnancies (preclinical losses) and miscarriages.Results
Data on 865 artificial cycles (45% of the total) and 1061 stimulated cycles (55%) were collected. Early pregnancy loss rate was significantly lower for stimulated cycles (34.2%) than for artificial cycles (56.9%), and the live birth rate was significantly higher for stimulated cycles (59.7%) than for artificial cycles (29.1%).Conclusion
In frozen embryo transfer, artificial cycles were associated with more early pregnancy loss and lower live birth rate than stimulated cycles.7.
Isabelle Cédrin-Durnerin Tiphaine Isnard Sarah Mahdjoub Charlotte Sonigo Alice Seroka Marjorie Comtet Charlène Herbemont Christophe Sifer Michael Grynberg 《Reproductive biomedicine online》2019,38(3):472-480
Research question
Is serum progesterone measurement on the day of embryo transfer associated with outcome of frozen–thawed embryo transfer (FET) in cycles using hormonal replacement therapy (HRT) for endometrium preparation?Design
This single-centre retrospective study assessed the relationship between serum progesterone on embryo transfer day and live birth rates in 227 FET cycles. Endometrial preparation was performed by sequential administration of vaginal oestradiol until endometrial thickness was >7 mm, followed by transdermal oestradiol combined with 600 mg vaginal micronized progesterone.Results
Mean serum embryo transfer day progesterone was 11.4 ng/ml. Serum progesterone <10 ng/ml was observed in 37% of cycles and was associated with significantly lower pregnancy (34% versus 48%, P= 0.04) and live birth rates (17% versus 31%, P= 0.01). Multivariate logistic regression analysis identified serum embryo transfer day progesterone as a significant prognostic factor for live birth rate (odds ratio [OR]: 2.75, 95% confidence interval [CI]: 1.40–5.43]). Receiver operator curve analysis for live birth rates by serum progesterone levels on embryo transfer day gave an area under the curve of 0.62 (95% CI: 0.53–0.72).Conclusions
The data show that serum progesterone concentration is associated with live birth rate. This outlines the importance of measuring serum progesterone in FET with HRT although progesterone monitoring is not usually performed in routine practice. However, the optimal timing for measurement and further adaptive management in the presence of low values remain to be determined. 相似文献8.
目的:比较口服地屈孕酮联合阴道用微粒化黄体酮黄体支持与肌肉注射黄体酮应用于冻融胚胎移植(FET)激素替代黄体支持的临床效果。方法:月经第3日起口服17β雌二醇片8 mg;第14日超声监测,同时测定血清E2,内膜≥8 mm、E2≥150 pg/ml时,加用口服地屈孕酮40 mg联合阴道用微粒化黄体酮软胶囊400 mg(A组)转化内膜,或肌注油剂黄体酮60 mg(B组),3~5 d后解冻第3~5日胚胎。结果:共完成1 805个FET激素替代周期,A、B组临床妊娠率分别为41.4%(389/940)、38.4%(332/865),种植率分别为26.2%(485/1 851)、23.8%(438/1 837),继续妊娠率分别为34.1%(321/940)、33.4%(289/865),组间均无统计学差异;A组流产率为19.8%(77/389),高于B组的13%(43/332)(P<0.05)。结论:FET激素替代周期中口服地屈孕酮与阴道塞安琪坦联合用药,简单方便,临床结果理想,可逐步替代肌肉注射油剂黄体酮。 相似文献
9.
Use of Crinone vaginal progesterone gel for luteal support in in vitro fertilization cycles 总被引:1,自引:0,他引:1
Chantilis SJ Zeitoun KM Patel SI Johns DA Madziar VA McIntire DD 《Fertility and sterility》1999,72(5):823-829
OBJECTIVE: To investigate the efficacy and safety of intravaginal Crinone 8% (Columbia Research Laboratories, Miami. FL) versus IM progesterone for luteal phase support after IVF-ET. DESIGN: Prospective open trial with comparison to historical controls. SETTING: University hospital. PATIENT(S): Two hundred six women undergoing IVF-ET. INTERVENTION(S): One hundred patients received Crinone vaginal progesterone gel (90 mg once daily) and 106 patients received IM progesterone (50 mg once daily) beginning on the evening of oocyte retrieval. MAIN OUTCOME MEASURE(S): Pregnancy and miscarriage rates, and midluteal serum progesterone levels. RESULT(S): Positive beta-hCG pregnancy rates, clinical pregnancy rates per transfer, and ongoing pregnancy rates were similar for the Crinone and IM progesterone groups. Women who received Crinone had higher rates of biochemical pregnancy loss but lower rates of clinical pregnancy loss (i.e., spontaneous abortion) than women who received IM progesterone. Midluteal serum progesterone concentrations were significantly higher in the IM progesterone group (94.3+/-8.8 ng/mL versus 57.7+/-7.4 ng/mL). Several women who received Crinone had vaginal bleeding 11-13 days after oocyte retrieval. CONCLUSION(S): For all age categories, positive beta-hCG and ongoing pregnancy rates were similar when Crinone or IM progesterone was given for luteal phase support in IVF-ET cycles, despite lower serum progesterone concentrations and higher rates of biochemical pregnancy loss with Crinone. Although the results of this study support the use of Crinone as an acceptable alternative for luteal support after IVF-ET, differences in bleeding patterns and rates of biochemical pregnancy loss demonstrate the need for a prospective randomized study. 相似文献
10.
Nasrin Saharkhiz Saghar Salehpour Shahrzad Zadehmodarres Sedighe Hoseini Leila Cheraghi 《Gynecological endocrinology》2016,32(3):213-217
The aim of the present study was to compare the efficacy, tolerability and patients’ satisfaction after the use of oral dydrogesterone with vaginal micronized progesterone for luteal-phase support (LPS) among infertile women undergoing in vitro fertilization (IVF). A total of 210 women (aged 20–40 years old) with a history of infertility, who underwent controlled ovarian stimulation for fresh intra-cytoplasmic sperm injection-embryo transfer cycles, were included in the study. Consequently, they were randomized to receive LPS with dydrogesterone 20?mg twice daily (n?=?96) or micronized progesterone 400?mg twice daily at the day of oocyte retrieval (n?=?114). The clinical success rate (31% versus 33%; p?=?0.888), miscarriage rate (5.0% versus 3.0%; p?=?0.721), ongoing pregnancy rate (30.0% versus 30.0%; p?=?1.000), implantation (22.0% versus 24.0%; p?=?0.254) and multiple pregnancy rate (5.30% versus 7.20%; p?=?0.394) were comparable among the two groups. Serum progesterone levels were significantly lower among the patients receiving dydrogesterone than the control group (13.62?±?13.83?ng/ml versus 20.66?±?18.09?ng/ml; p?=?0.001). However, there was no statistically significant difference regarding the patients’ satisfaction (p?=?0.825) and tolerability (0.790) between the two groups. Our results showed that oral dydrogesterone (40?mg/day) is as effective as vaginal micronized progesterone considering its clinical outcomes and patients’ satisfaction and tolerability, for LPS among women undergoing IVF. 相似文献
11.
Germond M Capelli P Bruno G Vesnaver S Senn A Rouge N Biollaz J 《Fertility and sterility》2002,77(2):313-317
OBJECTIVE: To compare the efficacy and the tolerability of two different vaginal formulations of micronized progesterone, Ellios and Utrogestan, used for luteal phase support after an in vitro fertilization (IVF) cycle. DESIGN: Cohort study. SETTING: Fertility center in a university hospital. PATIENT(S(: One hundred twenty-three women who underwent IVF/intracytoplasmic sperm injection (ICSI) stimulated cycles from October 1998 to March 2000, who had at least six follicles of > or =14 mm on the day of hCG administration. INTERVENTION(S): Patients received Ellios pessaries (2 times 200-mg pessary/day) or Utrogestan capsules (2 x 100-mg capsules, two times a day). Progesterone was administered from the day of oocyte pickup (day 0) until menses or up to 10 weeks in pregnant patients. MAIN OUTCOME MEASURE(S): Progesterone levels, pregnancy rate, and tolerability tested by patient questionnaire. RESULT(S): The progesterone levels on days 0, 9, 16 were not statistically different between the two formulations. The pregnancy rate were similar in groups 1 and 2 (25.5% vs. 18.6%), whereas tolerance was significantly better in group 1 versus group 2 (vaginal discharge: 43% vs. 82%). CONCLUSION(S): The efficacy of the two formulations of progesterone is comparable, although the patient tolerance for Ellios is better. 相似文献
12.
Crinone 8% vaginal progesterone gel results in lower embryonic implantation efficiency after in vitro fertilization-embryo transfer 总被引:1,自引:0,他引:1
OBJECTIVE: To evaluate the outcome of IVF-ET after the use of Crinone 8% (Wyeth-Ayerst Laboratories, Inc., Philadelphia, PA) vaginal progesterone gel and to compare these results with those seen in our program with the use of IM progesterone-in-oil. DESIGN: Retrospective cohort study. SETTING: A tertiary referral reproductive medicine unit. PATIENT(S): Patients <40 years of age undergoing IVF-ET cycles. INTERVENTION(S): Patients were treated with either Crinone 8% vaginal progesterone gel (90 mg) administered daily or IM progesterone-in-oil (50 mg) administered daily. MAIN OUTCOME MEASURE(S): Biochemical pregnancy rate, implantation rate, and clinical and ongoing pregnancy rates. RESULT(S): The use of Crinone 8% vaginal progesterone gel was associated with a lower implantation rate (16.6% versus 26.2%; odds ratio [OR] = 0.56; 95% confidence interval [CI], 0.35-0.89) compared with the use of IM progesterone-in-oil. Biochemical pregnancies were more common after the use of Crinone 8% vaginal progesterone gel as defined by either biochemical pregnancies per transfer (15.9% versus 5.7%; OR = 3.11; 95% CI, 1.17-8.32) or biochemical pregnancies as a proportion of positive serum hCG titers (29.2% versus 9.8%; OR = 3.80; 95% CI, 1.33-10.86). Clinical pregnancy rates also were lower with the use of Crinone 8% vaginal progesterone gel (36.4% versus 52.9%; OR = 0.51; 95% CI, 0.26-0.99). Conclusion(s): Implantation efficiency is reduced, as demonstrated by lower embryonic implantation rates and higher biochemical pregnancy rates, when Crinone 8% vaginal progesterone gel rather than IM progesterone-in-oil is used for luteal phase support after IVF-ET. 相似文献
13.
OBJECTIVE: To determine the effectiveness of two routes of progesterone supplementation by intramuscular vs. vaginal administration, for luteal phase support of patients undergoing in vitro fertilization (IVF) procedures. SETTINGS: Rush Presbyterian St' Lukes Medical Center and Rush Northshore Medical Center in Chicago, Illinois. MATERIALS AND METHODS: A total of 79 consecutive patients undergoing IVF procedures between August 1997 and July 1998 were assessed; 42 women received progesterone in oil intramuscularly (i.m.)--50-100 mg daily and in 37 patients progesterone was applied as intravaginal gel (80 mg daily), according to patient's preference. STUDY DESIGN: A chart review of the patients' data was performed. There were no statistical differences between the two groups of patients with respect to age, total number of ampoules of gonadotropins used during stimulation, number of oocytes retrieved and fertilized or number of embryos transferred. We then compared pregnancy rates per cycle and pregnancy rates per embryo transferred and miscarriage rates between two groups. Statistical analysis was performed using Student's t test. RESULTS: There were no statistically significant differences between two groups. The pregnancy rate per cycle for i.m. progesterone group was 33% and for vaginal gel group--25% (p = 0.42). Pregnancy rates per embryo transferred were also similar (8% for i.m. group and 5% for vaginal gel group (p = 0.42). Miscarriage rates were also within the same range: 0.083 for vaginal gel and 12% for i.m. group, (p = 0.48). CONCLUSIONS: The route of post-transfer progesterone administration does not appear to affect the pregnancy rate in IVF cycles. Therefore the least expensive and the most convenient route of progesterone administration could be utilized. 相似文献
14.
Olga Pustotina 《The journal of maternal-fetal & neonatal medicine》2018,31(14):1830-1838
Objective: To compare the efficacy of dydrogesterone, 17-OH progesterone (17OHP) and oral or vaginal micronized progesterone with cerclage for the prevention of preterm birth in women with a short cervix.Methods: The study included 95 women with singleton gestation and cervical length (CL) ≤?25?mm. Among these, 35 women were asymptomatic at 15–24?weeks and 60 had symptoms of threatened late miscarriage (LM) or preterm delivery (PD) at 15–32 weeks. Patients were randomized to receive dydrogesterone, 17OHP or oral/vaginal micronized progesterone; after one week of therapy 15 women underwent cerclage.Results: Efficacy of vaginal progesterone (VP) for the prevention of preterm birth reached 94.1%. In asymptomatic women pregnancy outcomes were comparable to cerclage. In women with threatened LM/PD, combination therapy with VP, indomethacin and treatment of bacterial vaginosis (BV) with the subsequent use VP until 36?weeks together with CL monitoring significantly decreased the rate of preterm birth (RR 0.01; 0.0001–0.24) and low birth weight (LBW) (RR 0.04; 0.01–0.96). CL increase during the first week of treatment with a subsequent plateau phase indicated treatment efficacy. Dydrogesterone, 17OHP, and micronized oral progesterone (OP) were associated with PD in 91.7% of women.Conclusions: Combination management strategy including VP significantly benefits pregnancy outcomes in women with a short cervix compared with cerclage. Dydrogesterone, 17OHP, and OP were not found to be efficacious. 相似文献
15.
Comparison of pregnancy outcomes of progesterone or progesterone + estradiol for luteal phase support in ICSI-ET cycles 总被引:6,自引:0,他引:6
Gorkemli H Ak D Akyurek C Aktan M Duman S 《Gynecologic and obstetric investigation》2004,58(3):140-144
OBJECTIVE: To find out the effect of estradiol with progesterone for luteal phase support in IVF-ICSI cycles. MATERIALS AND METHODS: Patients were accepted for treatment in the ART unit of Selcuk University, Meram Faculty of Medicine, between January 2001 and March 2003. The study was done in a prospective manner. The age range of 252 women was 19-41 years and the total number of cycles was 310. All patients were treated with a long ovulation induction protocol. Patients were treated and divided into two groups in a randomized manner: group I used only 600 mg/day divided into three equal doses of micronized progesterone vaginally, and group II used transdermal estradiol 100 microg/day + 600 mg/day vaginal micronized progesterone. RESULTS: 310 ICSI cycles were carried out in 252 infertile couples between January 2001 and March 2003. From 22 of these cycles, oocytes were retrieved but no embryos were developed. In the remaining 288 cycles there were embryo transfers. All embryo development was achieved by ICSI treatment. In 148 out of 288 cycles, the luteal phase was supported only by vaginal micronized progesterone (group I). On the other hand, the remaining 140 cycles received vaginal micronized progesterone plus transdermal estradiol 100 microg/day (group II). The number of beta-hCG-positive results in group I and group II were 20 (13.5 %) and 54 (38.5%) respectively. CONCLUSION: Adding estradiol to progesterone for luteal phase support in ICSI-ET cycles may increase implantation and pregnancy rates. 相似文献
16.
Wright KP Guibert J Weitzen S Davy C Fauque P Olivennes F 《Reproductive biomedicine online》2006,13(3):321-325
The objective of this study was to compare the implantation rate, pregnancy rate and endometrial thickness of frozen-thawed embryo transfers using endometrial preparation with either an artificial cycle or stimulated cycle. This was a prospective randomized trial at a single academic IVF centre. Seventy-seven patients undergoing artificial cycles received oral oestradiol; patients with endometrium < 7 mm on day 9-10 were switched to vaginal oestradiol. Eighty-six patients undergoing stimulated cycles received recombinant FSH followed by human gonadotrophin hormone injection. Vaginal progesterone was begun 2 or 3 days prior to embryo transfer. There was no difference in implantation rate (8.5% versus 7.3%), pregnancy rate (16% versus 13%), cancellation rate (both 23%) or endometrium thickness (8.7 +/- 1.1 mm versus 8.7 +/- 1.0 mm) between artificial and stimulated cycles. Stimulated cycles had a higher incidence of thin endometrium (27% versus 5%, P < 0.01). In artificial cycles, patients switched to vaginal oestradiol had improved pregnancy rate (31%) versus patients who received oral oestradiol alone (13%) (P = 0.05). It is concluded that artificial and stimulated cycles produce comparable pregnancy rates, implantation rates, cancellation rates and endometrial thickness, although stimulated cycles have a higher incidence of thin endometrium. Vaginal oestradiol supplementation improved implantation rates. 相似文献
17.
Po Mui Lam Mei Chun Cheung Lai Ping Cheung Hung Ingrid Lok Christopher John Haines 《Gynecological endocrinology》2013,29(12):674-680
Objective. To determine whether early luteal-phase vaginal progesterone supplementation improves the outcome of in vitro fertilization–embryo transfer (IVF-ET).Methods. A randomized, controlled trial was conducted on 197 women undergoing IVF-ET cycles with human chorionic gonadotropin (hCG) as the standard luteal-phase support. The participants were randomly assigned to either the study group or the control group. The study group was given 200 mg micronized progesterone vaginally three times per day starting in the afternoon of oocyte retrieval until the morning of embryo transfer, in addition to the standard hCG luteal-phase support. The control group received only the hCG support. The pregnancy rates and the implantation rates were measured.Results. There were no significant differences in pregnancy rates or implantation rates between groups. However, subgroup analysis revealed significantly higher pregnancy and implantation rates in the study group among those women with fibroids or difficult oocyte retrieval involving uterine puncture (38.7% vs. 15.4% and 26.8% vs. 9.4% respectively, both p = 0.04).Conclusion. Additional early luteal-phase vaginal progesterone supplementation may improve the outcome of IVF-ET in women with fibroids or difficult oocyte retrieval. 相似文献
18.
Marinov B Petkova S Dukovski A Georgiev G Garnizov T Manchev V Kolarov G Iunakova M 《Akusherstvo i ginekologii?a》2004,43(5):22-24
Utrogestan is a modern progesterone, which shows maximal effectiveness with minimal side effects. It is a natural progesterone in micronized form, which makes it suitable for oral administration and vaginal application with same effectiveness. The aim of our retrospective study was to evaluate the therapeutical effects of Utrogestan in women with threatened abortion in the first trimester. Our experience dated from about one year and a half. Sixty eight women were treated for threatened abortion with a daily dose of 400 mg Utrogestan. The treatment continued at least 14 days/average 21 days/. Utrogestan was administered orally twice daily. The main indications were first or consecutive threatened spontaneous abortion in first trimester. For the period of time no side effects and subjective complaints were established except particular cases of slight headache and dizziness after morning application. Sixty one of the sixty eight women were dehospitalised with healthy pregnancy with no side effects. In our experience we preferred to use the drug in women with lutein insufficiency before pregnancy. We conclude that Utrogestan can be widely applied in Obstetrics with the proper indications, such as threatened abortion in the first trimester. The prophylactic treatment in women with slighter complaints like dull pain and weight Utrogestan is applied one tablet twice daily. In graver cases the starting dosage is two tablets two or three times daily. 相似文献
19.
Dal Prato L Bianchi L Cattoli M Tarozzi N Flamigni C Borini A 《Reproductive biomedicine online》2008,16(3):361-367
The aim of this randomized study was to compare the efficacy of intramuscular progesterone (IMP) and progesterone in vaginal gel (VGP) at two different doses for luteal support in IVF. A total of 412 patients, aged between 28 and 37 years, were randomized into three groups. The day after oocyte retrieval each patient began supplementation with one of the following: IMP 50 mg daily (150 patients), VGP 90 mg once daily (143 patients), or VPG 90 mg twice daily (148 patients). No significant difference was found between the three groups in any of the endpoints. The rate of positive beta-human chorionic gonadotrophin per transfer was 38.4% with IMP, 35.0% with VPG once daily and 43.1% with VPG twice daily. Clinical pregnancy rate per transfer and implantation rate were 32.6% and 19.6% with IMP, 26.3% and 16.4% with one dose of VGP, and 37.2% and 21.1% with two doses of VGP. Live birth rate per transfer was 26.1%, 23.4% and 29.9%, respectively. Progesterone vaginal gel can be successfully used as an alternative to intramuscular progesterone for luteal support in IVF. One daily dose appears sufficient to induce clinical pregnancies and live births at a rate comparable to intramuscular supplementation. 相似文献
20.
Friedler S Gilboa S Schachter M Raziel A Strassburger D Ron El R 《Reproductive biomedicine online》2006,12(1):27-32
Due to inherent differences between gonadotrophin-releasing hormone (GnRH) antagonists and agonists, their late effect on ovarian steroidal production during the luteal phase of IVF cycles may differ. The aim of this study was to characterize and compare the luteal phase hormonal profile after the use of GnRH antagonists or agonists in ovarian stimulation protocols for IVF, in non-conception cycles, to avoid the effect of human chorionic gonadotrophin (HCG) during the luteal phase in conception cycles. Seventy-eight normo-ovulatory patients <35 years old, undergoing IVF due to male or tubal infertility were randomly allocated either to a GnRH antagonist (study group) or GnRH agonist treatment (control group). Similar standard luteal support was given to all patients, using vaginal micronized progesterone. In non-conception cycles, no statistically significant differences were found comparing luteal phase. oestradiol or progesterone levels in the study and control groups. No statistically significant differences were found comparing the hormonal profile dynamics, the mid-luteal (HCG day +8) oestradiol/progesterone ratio and the percentage of mid-luteal oestradiol decline between the study and control groups. In conclusion, similar characteristics and dynamics of luteal phase oestradiol and progesterone were demonstrated comparing ovarian stimulation for IVF using GnRH agonist or antagonists, under similar luteal support. 相似文献