臨床婦人科産科67巻10号

2013年10月発行

今月の臨床 ART成功の秘訣─どうすれば妊娠率は向上するか

黄体期補充・妊娠初期管理法

著者： 井田守¹ 福田愛作¹

所属機関： ¹IVF大阪クリニック

ページ範囲：P.1052 - P.1057

文献概要

●黄体期補充として経口プロゲスチンを主として投与し，hCGとプロゲステロン筋注を黄体期初期にのみ併用する．

●OHSS発症が懸念される場合，黄体期にはhCGを投与しない．

●妊娠9週までホルモン剤投与を行う．

参考文献

1） Fanchin R, Righini C, Olivennes F, et al : Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilization. Hum Reprod 13 : 1968─1974, 1998

2） Rosenberg SM, Luiano AA, Riddick DH, et al : The luteal phase defect : the relative frequency of and encouraging response to treatment with vaginal progesterone. Fertil Steril 34 : 17─20, 1980

3） Coutifarris C, Myer WR, Guzick DS, et al : Histological dating of timed endometrial biopsy tissue is not related to fertility status. Fertil Sreril 825 : 1264─1272, 2004

4） Jones GS, Garcia J, Acosta A : Luteal phase evaluation in in-vitro fertilization. In : Edwards RG, Purdy JM, eds. Human conception in vitro. Academic Press, London, uk, pp297─310, 1982

5） Daya S : Efficacy of progesterone support in the luteal phase following in-vitro fertilization and embryo transfer : meta-analysis of clinical trials. Hum Reprod 3 : 731─734, 1988

6） Smith J, Bourgain C, Van Waesberghe L, et al : A Prospective randomized study on estradiol valerate supplementation in addition to intravaginal micronized progesterone in buserelin and HMG-induced superovulation. Hum Reprod 8 : 40─45, 1993

7） Prittts EA, Atwood AK : Luteal phase support in infertility treatment : a meta-analysis of the randomized trials. Hum Reprod 17 : 2287─2299, 2002

8） Ghosh D, Stewart DR, Nayak NR, et al : Serum concentrations of oestradiol-17beta, progesterone,relaxin and chorionic gonadotrophin during blastcyst implantation in natural pregnancy cycle and in embryo transfer cycle in the rhesus monkey. Hum Reprod 12 : 914─920, 1997

9） Daya S, Gundy J : Luteal phase support in assisted reproduction cycles.［Review］. Cochlane Database Syst Rev : CD004830, 2004

10） Mochter MH, Hogerzei HV, Mol BW : Progesteronealone versus progesterone combined with HCG as luteal support in GnRHa/HMG induced IVF cycles : a randomized trial. Hum Reprod 11 : 1602─1605, 1996

11） Leeton J, Trouson A, Jessup D : Support of the luteal phase in in vitro fertilization programs : results of a controlled trial with intramuscular prolution. J In Vitro Fert Transf 2 : 166─169, 1985

12） Posaci C, Smitz J, Camus M, et al : Progesterone for the luteal support of assisted reproductive technologies : clinical options. Hum Reprod 15（Suppl 1） : 129─148, 2000

13） Bouckaert Y, Robert F, Englert Y, et al : Acute eosinophilic pneumonia associated with intramuscular administration of progesterone as luteal phase support after IVF : case report. Hum Reprod 19 : 1806─1810, 2004

14） Licciaridi FL, Kwiatkowski A, Noyes NL, et al : Oral versus intramuscular progesterone for in vitro fertilization : a prospective randomized study. Fertil Steril 71 : 614─618, 1999

15） Norman TR,Morse CA, Dennerstein L : Comparative bioavailability of orally and vaginally administered progesterone. Fertil Steril 56 : 1034─1039, 1991

16） Ashalatha Ganash A, Chakravorty N, Mukherjee R, et al : Comparison of oral dedrogesterone with progesterone gel and micronized progesterone for luteal support in 1373 women undergoing in vitro fertilization : a randomized clinical study. Fertil Steril 95 : 1961─1965, 2011

17） William K : Hubbard, Acting Deputy Commissioner for Policy. Federal Register : 64（70） : Proposed Rules. FR Document 99─9146, April 13, 1999

18） Bulletti C, de Ziegler D, Flamigni C, et al : Targeted drug delivery in gynecology : the first uterine pass effect. Hum Reprod 12 : 1073─1079, 1997

19） Miles RA, Paulson RJ, Lobo RA, et al : Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes : a comparative study. Fertil Steril 62 : 485─490, 1994

20） Ludwig M, Finas A, Katalinic A, et al : Prospective randomized study to evaluate the success rates using hCG, vaginal progesterone or a combination of both for luteal phase support. Acta Obstet Gynecol Scand 80 : 574─582, 2001

21） Caspo AI, Pulkkinen MO, Kaihola HL : The relationship between the timing of luteectomy and complete abortions. Am J Obstet Gynecol 118 : 985─989, 1974

22） Caspo AI, Pulkkinen MO : Wiest WG : Effect of luteectomy and progesterone replacement therapy in early pregnant patients. Am J Obstet Gynecol 115 : 759─765, 1973