经皮雌二醇凝胶与口服戊酸雌二醇片在冻融胚胎移植中的临床应用疗效比较

中国临床药理学与治疗学 ›› 2017, Vol. 22 ›› Issue (10): 1162-1166.

经皮雌二醇凝胶与口服戊酸雌二醇片在冻融胚胎移植中的临床应用疗效比较

金聪聪，王佩玉，林佳，周玮，杨海燕

温州医科大学附属第一医院生殖医学中心，温州 325000，浙江

收稿日期:2017-04-05 修回日期:2017-07-14 出版日期:2017-10-26 发布日期:2017-11-13
通讯作者: 杨海燕，女，硕士，副主任医师，主要从事生殖不孕工作。 Tel：0577-88069393 E-mail：YHYPG@sohu.com
作者简介:金聪聪，女，硕士，住院医师，主要从事生殖不孕工作。 Tel：0577-88069393 E-mail：jcc8576@163.com

A comparison of clinical applications of transdermal estradiol and estradiol valerate on endometrial receptivity in frozen-thawed embryo transfer cycles

JIN Congcong, WANG Peiyu, LIN Jia, ZHOU Wei, YANG Haiyan

Department of Reproductive Medicine, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China

Received:2017-04-05 Revised:2017-07-14 Online:2017-10-26 Published:2017-11-13

摘要/Abstract

摘要：

目的: 在冻融胚胎激素替代方案（HRT）中，比较给药途径不同的两种雌激素对冻融胚胎移植（FET）临床结局的影响。方法: 选取2016年7月至2016年12月在本院行FET的患者共120例，根据给药途径分为A组及B组。A组为经皮雌二醇凝胶给药激素替代方案准备内膜，共60个周期，B组为口服戊酸雌二醇激素替代方案准备内膜，共60个周期。比较两组间的基本情况、子宫内膜厚度、雌激素使用量、雌激素使用时间、转化日激素水平、种植率及临床妊娠率等指标。结果: 两组间患者的年龄、体重指数、不孕年限、基础激素水平均无统计学差异（P>0.05）。两组间患者的转化日子宫内膜厚度、转化日激素水平、移植胚胎数、种植率、流产率、双胎妊娠率比较也均无统计学差异(P>0.05)。A组的HCG阳性率及临床妊娠率（63.63%及52.72%）略高于B组（61.11%及46.29%），差异没有统计学意义（P>0.05）。A组的雌激素使用量及雌激素使用天数［（102.68±34.10） mg；(16.80±4.02) d］均明显高于B组［（85.52±17.18）mg；(12.64±2.52) d］，差异有统计学意义（P<0.05）。结论: 在FET治疗中，经皮雌二醇凝胶HRT方案可以获得与口服戊酸雌二醇HRT相类似的临床妊娠率，对于口服雌激素有胃肠道症状或肝肾功能、血脂异常的患者可作为首选，但其使用量及使用时间明显增加，是否作为常规推荐尚值得商榷。

关键词: 雌二醇, 冻融胚胎移植, 经皮, 子宫内膜准备, 妊娠结局

Abstract:

AIM: To compare the clinical outcome of two endometrial preparation protocols (oral estradiol vs 17β-estradiol transdermal gel) in frozen-thawed blastocyst transfer. METHODS: One hundred and twenty FET cycles were analyzed from July 2016 to December 2016. All cases were divided into two groups: group A (n=60) received transdermal gel application for 60 cycles, while group B received (n=60) oral estradiol valerate for 60 cycles. Patient's age, basic endocrine, endometrial thickness on the day of progesterone initiation, high quality embryo rate, mean number of embryo transferred per patient, implantation rate, clinical pregnancy rate, early abortion rate and ectopic pregnancy rate were compared between the two groups. RESULTS: Clinical pregnancy rate and implantation rate of group A （63.63% and 52.72%） were higher than those of group B（61.11% and 46.29%, respectively）, but there were no statistically significant difference (P>0.05). The total amount of estradiol used［(102.6.8±34.10 vs 85.52±17.18) mg］ in group A was significantly higher than that in group B(P<0.05), and the total duration of estradiol used［(16.80±4.02) vs (12.64±2.52) d］ in group A was significantly higher than that in group B (P<0.05)．No significant differences of other indicators were observed between the two groups. CONCLUSION: In frozen-thawed embryo transfer, estradiol transdermal gel endometrial preparation protocol can obtain the similar pregnancy rate compared with taking estradiol valerate . Estradiol transdermal gel can be used as an effective clinical method for patients with abnormal liver function and hyperlipidaemia. Yet, the dosage and span time increased, estradiol transdermal gel as a regular recommendation still need further discussion.

Key words: estradiol, frozen-thawed embryo transfer, transdermal, endometrial preparation, pregnancy outcome

中图分类号:

金聪聪，王佩玉，林佳，周玮，杨海燕. 经皮雌二醇凝胶与口服戊酸雌二醇片在冻融胚胎移植中的临床应用疗效比较[J]. 中国临床药理学与治疗学, 2017, 22(10): 1162-1166.

JIN Congcong, WANG Peiyu, LIN Jia, ZHOU Wei, YANG Haiyan. A comparison of clinical applications of transdermal estradiol and estradiol valerate on endometrial receptivity in frozen-thawed embryo transfer cycles[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2017, 22(10): 1162-1166.

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