Objective: To analyze the effect of vaginal capsule of micronized progesterone supplementation during luteal phase in IVF-ET cycles.Methods: A total of 769 IVF cycles used progesterone supplementation were evaluated retrospectively. The patients were divided into 6 groups according to the regimen of progesterone supplementation in luteal phase. One hundred and forty IVF cycles were administrated vaginal capsule of progesterone in group A, 53 cycles intramuscular (IM) injection of progesterone in group B, 228 cycles vaginal capsule of progesterone and hCG on day 5 after embryo transfer (ET) in group C, 85 cycles IM progesterone and hCG on day 5 after ET in group D, 161 cycles vaginal capsule of progesterone and hCG on day 7 after ET in group E, 102 cycles IM progesterone and hCG on day 7 after ET in group F.Results; During the luteal phase, the progesterone levels were lower in the groups used vaginal capsule of progesterone than those used IM progesterone on day 5 after ET. The progesterone levels were significantly lower in Group C than those in Group D [(71. 96 + 36. 11) nmol/L vs. (83. 34 + 23. 30) nmol/ L,-x±s](P<0. 01), and they were significantly lower in Group E than in Group F [(130. 45 + 56. 46) nmol/L vs. (144. 93±46. 09) nmol/L ](P<0. 05). The progesterone levels on day 7 after ET in Group E were significantly lower than in Group F[(59. 66 + 29. 01) nmol/L vs. (80. 01 + 24. 28) nmol/L](P< 0. 01). The implantation rate of women used vaginal capsule of progesterone was significantly higher than that with IM progesterone (43. 7% vs 33. 8%, P<0. 01), but there were no significant differences in pregnancy rate and miscarriage rate (58. 4% vs 53. 3%, P = 0. 21; 2. 9% vs 6. 3% P = 0. 11, respectively).Conclusions: It is suggested that the supplementation of vaginal micronized progesterone is reasonable for luteal support in women undergoing IVF-ET with gonadotropin-releasing hormone agonist (GnRH-a) long protocol.%目的 探讨在长方案控制性超排卵的体外受精-胚胎移植(IVF-ET)周期阴道应用黄体酮胶囊进行黄体支持的可行性. 方法 对769个IVF-ET周期的临床资料及妊娠结局进行回顾性分析,根据黄体支持用药方案不同分为六组:A组,140周期,黄体酮胶囊；B组,53周期,黄体酮针剂；C组,228周期,黄体酮胶囊+移植后D5天注射人绒毛膜促性腺激素(hCG);D组,85周期,黄体酮针剂+移植后D5天注射hCG;E组,161周期,黄体酮胶囊+移植后D7天注射hCG;F组,102周期,黄体酮针剂+移植后D7天注射hCG.所有黄体酮胶囊均采用阴道给药的方式. 结果 阴道应用黄体酮胶囊进行黄体支持组ET后D5天的血清孕酮水平低于肌注黄体酮进行黄体支持者,其中C组与D组相比,E组与F组相比,差异具有统计学意义[(71.96±36.11)nmol/L vs (83.34±23.30) nmol/L,P＜0.01; (130.45±56.46) nmol/L vs (144.93±46.09)nmol/L,P＜0.05].E组ET后D7天的血清孕酮水平显著低于F组[(59.66±29.01)nmol/L vs (80.01±24.28) nmol/L,P＜0.01].阴道用黄体酮胶囊进行黄体支持组与肌注黄体酮组比较,阴道用药组临床妊娠率略高于肌注黄体酮组,但差异无统计学意义(58.4％ vs 53.3％ P=0.21),前者的胚胎种植率显著高于后者(43.7％ vs 33.8％,P＜0.01),两组的流产率无统计学差异(2.9％ vs 6.3％,P=0.11). 结论 长方案IVF-ET周期采用黄体酮胶囊阴道用药是一种切实可行的黄体支持方案.
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