中国合理用药探索2025，Vol.22Issue(12)：89-94,6.DOI:10.3969/j.issn.2096-3327.2025.12.012
孕酮暴露时长与胚胎发育天数对激素替代治疗-冻融胚胎移植周期活产率的影响
Effects of Progesterone Exposure Duration and Day of Embryo Development on Live Birth Rate in Hormone Replacement Therapy-Frozen-Thawed Embryo Transfer Cycles
摘要
Abstract
Objective:To investigate the effect of progesterone exposure duration and day of embryo development on live birth rate in hormone replacement therapy(HRT)-frozen-thawed embryo transfer(FET)cycles.Methods:A retrospective analysis was performed on 3381 patients who underwent HRT-FET cycles at the Department of Reproductive Health and Infertility of our hospital between June 2013 and June 2024.The patients were assigned to four groups based on the duration of progesterone exposure(P days)and the day of embryo development(D days):P3-D3,P3-D4,P4-D3,and P4-D4.The baseline characteristics and clinical outcomes[primary outcome(live birth rate),secondary outcomes(implantation rate,biochemical pregnancy rate,clinical pregnancy rate,miscarriage rate),perinatal outcomes(neonatal malformation rate,preterm birth rate,and low birth weight rate)]were compared among the groups.Results:No statistically significant differences were observed in baseline characteristics among the four groups(P>0.05).When the duration of progesterone exposure was synchronized with the day of embryo development,the P4-D4 group showed higher rates of live birth(47.6%vs 30.4%,P<0.001),implantation(41.2%vs 25.1%,P<0.001),and clinical pregnancy(58.9%vs 44.3%,P<0.001),along with a lower miscarriage rate(17.2%vs 26.7%,P=0.025),compared to the P3-D3 group.With a fixed duration of progesterone exposure,the live birth rate in the P3-D4 group was higher than that in the P3-D3 group(44.7%vs 30.4%,P=0.005).Likewise,the live birth rate in the P4-D4 group was higher than that in the P4-D3 group(47.6%vs.30.8%,P<0.001).With a fixed day of embryo development,no statistically significant differences were observed in all clinical outcomes between the P3-D3 group and the P4-D3 group or between the P3-D4 group and the P4-D4 group(P>0.05).Conclusion:In HRT-FET cycles,adopting a P4-D4 synchronized transfer strategy significantly optimized live birth outcomes.Regardless of progesterone exposure duration(3 or 4 days),the transfer of day 4(D4)embryos yielded a significantly higher live birth rate than the transfer of day 3(D3)embryos.With a fixed embryo developmental stage(D3 or D4),progesterone exposure duration(3 or 4 days)showed no significant effect on clinical outcomes.关键词
孕酮/胚胎发育/冻融胚胎移植/激素替代治疗/活产率Key words
progesterone/embryo development/frozen-thawed embryo transfer/hormone replacement therapy/live birth rate分类
医药卫生引用本文复制引用
FAN Lin,WANG Yu-jiang,LIU Feng-hua,ZHANG Xi-qian,XIAO Zong-hui..孕酮暴露时长与胚胎发育天数对激素替代治疗-冻融胚胎移植周期活产率的影响[J].中国合理用药探索,2025,22(12):89-94,6.基金项目
广东省医学科学技术研究基金项目(A2022098) （A2022098）
