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目的探讨激素替代-冻融胚胎移植周期阴道用黄体酮制剂的临床有效性、不良反应及对策。方法将2012年1月一2013年1月在上海交通大学医学院附属瑞金医院生殖医学中心行激素替代-冻融胚胎移植的患者358个周期进行随机分组,分别采用肌注黄体酮和阴道用黄体酮两种剂型进行孕酮补充,观察两组患者的临床结局以及不良反应发生率。结果肌注组149个周期的临床妊娠率和活胎出生率分别为43.6%和38.9%,阴道用药组209个周期的临床妊娠率和活胎出生率分别为44.5%和39.2%,相比较P>0.05;局部不良反应发生率肌注组显著高于阴道用药组(12.3%V.S.0%),阴道出血发生率阴道用药组显著高于肌注组(69.6%V.S.18.8%)。结论阴道用黄体酮的临床效果与肌注相同,局部不良反应显著降低,其阴道出血发生率较高但并未影响临床妊娠结局。
Objective To investigate the clinical efficacy, adverse reactions and countermeasures of vaginal progesterone preparations during hormone replacement - frozen and thawed embryo transfer. Methods 358 cycles of hormone replacement-freeze-thaw embryo transfer were performed in January 2012-January 2013 in Ruijin Hospital of Reproductive Medicine Center, Shanghai Jiaotong University School of Medicine. The patients were randomly divided into three groups: intramuscular injection of progesterone and vaginal corpus luteum Ketone two dosage forms for progesterone replacement were observed in two groups of patients with clinical outcomes and the incidence of adverse reactions. Results The clinical pregnancy rate and live birth rate in 149 cycles of intramuscular injection group were 43.6% and 38.9%, respectively. The clinical pregnancy rate and live birth rate in 209 cycles of vaginal administration group were 44.5% and 39.2% respectively, compared with P> 0.05 The incidence of local adverse reactions in intramuscular injection group was significantly higher than that in vaginal injection group (12.3% VS0%). The incidence of vaginal bleeding in vaginal drug group was significantly higher than that in intramuscular injection group (69.6% vs18.8%). Conclusions The clinical effect of vaginal progesterone is the same as that of intramuscular injection. The local adverse reactions are significantly reduced. The incidence of vaginal bleeding is higher but it has no effect on clinical pregnancy outcomes.