地屈孕酮在促排卵周期宫腔内人工授精黄体支持中的应用

摘要

Objective:To explore the effect of dydrogesterone for luteal support in the hyperstimulation cycle onthe outcome of artificial insemination.Methods:A total of 617 patients(1 594 cycles) underwent to our center for intrauterine insemination from 2013 to 2014.Three hundred and sixty seven patients completed 367 natural cycles for monitoring ovulation before IUI cycle as the natural cycle group.Twenty eight hyperstimulation cycles without luteal support were canceled IUI as canceled IUI without luteal support group.According to the luteal support method after IUI,the patients were divided into two groups:the patients were given dydrogesterone in group A(1 076 cycles),and the patients were administrated progesterone capsules in group B(518 cycles).The luteal phase days and the incidence of corpus luteum insufficiency were compared among the groups.The rates of pregnancy,abortion,ectopic pregnancy,live birth and the incidence of fetal abnormalities were compared between group A and group B.Results:The luteal phase days were not significantly different between groups A and group B [(13.80± 0.80) vs.(13.83±0.90) days],but which were significantly higher than those in the group without luteal support [(12.00± 1.12) days] (P＜0.05).The incidence of corpus luteum insufficiency in group A and group B [0.86％ and 0.78％,respectively] was significantly lower than that in the natural cycle group (4.36 ％) and the group without luteal support(32.14 ％)(P＜0.05).There were no differences in rates of pregnancy,miscarriage,ectopic pregnancy,live birth,neonatal birth weight,Apgar score,and fetal abnormalities between the group A and B(P＞0.05).Conclusions:Application of dydrogesterone for luteal support is effective and safe in the hyperstimulation cycle of artificial insemination.%目的 探讨促排卵周期宫腔内人工授精(IUI)中使用地屈孕酮行黄体支持对妊娠结局的影响. 方法 2013～2014年617例患者于大连市妇女儿童医疗中心行促排卯IUI助孕,实施IUI 1 594个周期.367例患者进入IUI周期前完成367个自然周期监测排卵,列为自然周期组,记录黄体期天数;28个促排卵未行黄体支持的周期取消IUI列为取消IUI未行支持组;根据不同的黄体支持方法将患者分为两组:用达芙通行黄体支持者为A组(1 076个周期),用琪宁行黄体支持者为B组(518周期).比较各组的黄体期天数和黄体功能不足发生率;比较A、B两组的一般情况及临床妊娠率、早期流产率、异位妊娠率、活产率及新生儿情况等. 结果 A、B两组的黄体期天数相似[分别为(13.80±0.80)d和(13.83±0.90)d],均显著高于取消IUI未行支持组[(12.00±1.12) d](P＜0.05).A、B组黄体功能不足的发生率[分别为0.86％和0.78％]显著低于自然周期组(4.36％)和取消IUI未行支持组(32.14％)(P＜0.05).A、B两组的临床妊娠率、早期流产率、异位妊娠率、活产率、新生儿出生体重、Apgar评分和畸形率等比较均无显著性差异(P＞0.05). 结论 促排卵周期1UI中使用地屈孕酮行黄体支持是安全有效的,可以作为促排卵周期IUI黄体支持的方法之一.