不同黄体支持方案在激素替代周期冻胚移植中的临床疗效及成本分析

目的:探究不同黄体支持方案对激素替代周期冻融胚胎移植（hormone replacement therapy for frozen-thawed embryo transfer，HRT-FET）妊娠结局的影响及成本差异，寻找具有高成本-效果比的黄体支持方案。方法:采用回顾性队列研究，选取2017年10月至2019年4月...

Clinical efficacy and cost-effectiveness analysis in patients with hormone replacement for frozen-thawed embryo transfer under different luteal support scheme

Objective To evaluate the differences in pregnancy outcomes of patients and cost variance with hormone replacement therapy for frozen-thawed embryo transfer(HRT-FET)under different luteal support scheme.Methods A retrospective cohort study was performed.A total of 1009 cycles of HRT-FET from October 2017 to April 2019 were collected and the patients were recruited from Reproductive Hospital Affiliated to Shandong University.According to different luteal support protocol,patients in group A(n=504)were treated with oral progesterone capsule while patients in group B(n=505)were treated with progesterone vaginal sustained release gel and dydrogesterone.The pregnancy outcomes,pregnancy complications and cost-effectiveness ratio were compared between the two groups.Results There were no significant differences in embryo implantation rate,clinical pregnancy rate,multiple pregnancy rate,ectopic pregnancy rate,early and late abortion rate,premature birth rate,live birth rate,incidence of pregnancy complications and birth defect rate between the two groups(all P>0.05).But the incidence of vaginal bleeding in group B was significantly higher than that in group A[6.0%(30/504)vs.10.3%(52/505),P=0.015],cost-effectiveness ratio(C/E)in group A was better than that in group B(17.76 vs.77.30).Conclusion For patients undergoing HRT-FET cycles,oral progesterone capsule can reduce vaginal bleeding and medical cost,while achieving a pregnancy outcome similar to that of progesterone vaginal sustained release gel and dydrogesterone,so it can be used as a luteal support scheme in clinic.