【摘要】 目的比较辅助生殖技术中黄体酮阴道缓释凝胶与肌肉注射黄体酮两种黄体支持方式对妊娠结局的影响及副反应评价。方法计算机检索PubMed、Medline、CNKI和万方数据库,查找所有比较黄体酮阴道缓释凝胶与肌肉注射黄体酮进行黄体支持的临床随机对照研究(RCT),时间为数据库建立至2017年12月1日。由2人分别按纳入/排除标准检索文献、筛选、质量评价及提取资料,RevMan 5.2进行Meta分析。结果纳入RCT 14个,患者4 386例。妊娠结局对比:两种给药方式进行黄体支持对改善患者的临床妊娠率[RR=0.99,95%CI(0.92,1.07),P=0.86]、改善继续妊娠率[RR=1.06,95%CI(0.94,1.19),P=0.32]、降低异位妊娠率[RR=0.84,95%CI(0.48,1.47),P=0.54]、降低流产率[RR=0.92,95%CI(0.75,1.14),P=0.45]、提高活产率[RR=0.99,95%CI(0.89,1.09),P=0.76]均无统计学差异;副反应发生率:与肌肉注射黄体酮相比,黄体酮阴道缓释凝胶副反应发生率较低[RR=0.23,95%CI(0.05,0.93),P=0.04]。结论黄体酮阴道缓释凝胶与肌肉注射黄体酮在辅助生殖技术行黄体支持均有较好的疗效,但黄体酮阴道缓释凝胶副反应发生率较低,患者满意度较好,可在临床推广使用。更多还原

【Abstract】 Objective:To compare the pregnancy outcome and side effects between progesterone sustained-release vaginal gel and intramuscular progesterone injection for luteal phase support treatment in assisted reproductive process.Methods:The clinical randomized controlled trials(RCT)which compared the effect of luteal phase support between progesterone sustained-release vaginal gel and intramuscular progesterone injection in assisted reproductive process were searched from the databases such as PubMed,Medline,CNKI and Wanfang from their establishment to December 1 st 2017.The retrieval of papers,screening,quality evaluation and extraction of information in accordance with the inclusion/exclusion criteria were performed by two reviewers independently.The meta-analyses were performed by using the RevMan 5.2 software.Results: Fourteen studies involving 4 386 patients were included.There were no significant differences in clinical pregnancy [RR=0.99,95%CI(0.92,1.07),P=0.86],ongoing pregnancy [RR=1.06,95%CI(0.94,1.19),P=0.32],ectopic pregnancy rate[RR=0.84,95%CI(0.48,1.47),P=0.54],abortion rate[RR=0.92,95%CI(0.75,1.14),P=0.45],and live birth rate[RR=0.99,95%CI(0.89,1.09),P =0.76]between progesterone sustained-release vaginal gel and intramuscular progesterone injection.The side effect incidence of progesterone sustained-release vaginal gel was lower than intramuscular progesterone injection[RR=0.23,95%CI(0.05,0.93),P=0.04].Conclusions:Both of progesterone sustained-release vaginal gel and intramuscular progesterone injection have good effects on luteal phase support in assisted reproductive process.However,the progesterone sustained-release vaginal gel has lower side effects incidence.Its the patient satisfaction is better,and it is worth to promote clinical use.更多还原