Effect of different progesterone administration methods on pregnancy and delivery outcomes after frozen embryo transfer with hormone replacement regimen to prepare the endometrium
Objective To explore the effects of different progesterone administration methods on pregnancy and de-livery outcomes in frozen embryo transfer(FET)cycles with hormone replacement regimen to prepare the endometrium.Methods A total of 3 357 patients who underwent the first cycle of frozen single blastocyst transfer and used hormone re-placement regimen to prepare their endometrium were selected and divided into the intramuscular progesterone group(IMP group)of 749 cases,the oral dydrogesterone combined with vaginal micronized progesterone capsule group(DYD-VPC group)of 2 249 cases,and the oral dydrogesterone combined with vaginal progesterone gel group(DYD-VPG group)of 359 cases according to the different administration methods of progesterone.Differences in basic clinical characteristics,maternal complications and pregnancy outcomes were compared among the three groups.Results There were no signifi-cant differences in age,BMI,duration of infertility,being nulliparous,primary infertility,the number of antral follicles,the number of oocytes retrieved,endometrial thickness before FET,the proportion of patients with PCOS,history of caesar-ean section,development time of transferred embryos,or other baseline data among the three groups(all P>0.05).There were no significant differences in live birth rate,biochemical pregnancy rate,biochemical pregnancy abortion rate or clini-cal pregnancy loss rate among the three groups(all P>0.05).The caesarean section rate was higher in the IMP group than in the DYD-VPC and DYD-VPG groups(83.42%vs.76.88%vs.73.41%,all P<0.05).There were no significant dif-ferences in the incidence of pregnancy and neonatal complications such as preterm birth,macrosomia,low birth weight(LBW),large for gestational age(LGA),small for gestational age(SGA),hypertensive disorders of pregnancy(HDP)or gestational diabetes mellitus(GDM)among the three groups(all P>0.05).Multivariate Logistic regression analysis showed that intramuscular progesterone was associated with an increased risk of caesarean section after adjusting for con-founding factors.Conclusion In frozen embryo transfer cycles with hormone replacement regimens to prepare the endo-metrium,oral dydrogesterone combined with vaginal progesterone has the same clinical pregnancy and live birth rates as in-tramuscular progesterone,but the caesarean section rate is lower.
万方数据
维普
