Препараты натурального микронизированного прогестерона для заместительного гормонального лечения в репродуктологии

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Аннотация

Исследована эффективность микронизированного прогестерона (препараты утрожестан T BI Laboratories Besins-Iscovesco; ProgestanT; LugesteronT Leiras Оу) для поддержания беременности в условиях отсутствия эндогенного синтеза половых стероидов в циклах вспомогательных репродуктивных технологий. Прослежены 64 цикла подготовки эндометрия к переносу эмбриона и развития беременности (29 клинических и два биохимических). Микронизированный прогестерон назначали в форме вагинальных капсул по стандартному протоколу за 4-5 дней до переноса эмбрионов до 8-11 недель беременности. Исследование подтвердило высокую эффективность препаратов микронизированного прогестерона для вагинального введения, о чем свидетельствует частота наступления беременности (43.5%) и дальнейшее ее физиологическое течение.

Об авторах

М. А. Репина

Санкт-Петербургская медицинская академия последипломного образования МЗ РФ; Российско-Финская клиника «AVA-Peter»

Автор, ответственный за переписку.
Email: info@eco-vector.com
Россия, Санкт-Петербург; Санкт-Петербург

Н. В. Корнилов

Санкт-Петербургская медицинская академия последипломного образования МЗ РФ; Российско-Финская клиника «AVA-Peter»

Email: info@eco-vector.com
Россия, Санкт-Петербург; Санкт-Петербург

Список литературы

  1. Abdalla H.I., Wren М.Е., Thomas А. Et al. Age of the uterus does not affect pregnancy or implantation rates; a study of egg donation in women of different ages sharing oocytes fron the same donor. Hum, Reprod, 1997; 12(4): 827-829.
  2. Arafat E.S., Hargrove J.T., Maxson W.S. etal. Sedative and hypnotic effects of oral administration of micronized P4 may be mediated through its metabolites. Am. J. Obstet. Gynecol., 1988; 159: 1203-1209.
  3. Beckers N.G.M., Laven J S.E., Eijkemans M.J.C. etal. Follicular and luteal phase characteristics following early cessation of gonadotrophinreleasing hormone agonist during ovarian stimulation for invitro fertilization. Hum. Reprod. 2000; 15(1): 43-49.
  4. Beifla J.L., Dumont M., Levardion M. et al. Effects de la progesterone naturelle micronisee sur le foie au cours du troisième trimestre de la grossesse. Contracept. Fertil. Sex. 1997; 25:165- 169.
  5. Bourgain C., Devroey P., Van Waesberghe L. ét al. Effects of natural progesterone on the morphology of the endometrium in patients with primary ovarian.failure. Hum. Reprod. 1990; S: 537-543.
  6. Buletti C., Jasonni V.M., Ciotti P.M. et al. Extraction of oestrogens by human perfused h uterus. Effects of membrane permeability and binding by serum proteins on differential influx into endometrium and myometrium. Am. J. Obstet. Gynecol. 1988; 159:509.
  7. Buletti C., de Ziegler D., Flagmini C., et al. Targeted drug delivery in gynaecology: the first uterine pass effect. Hum. Reprod. 1997; 12: 1073- 1079.
  8. Chillik C., Agolti G., Borghi M., et al. Randomized study on the use of vaginal is intramuscular progesteron in ICSI. Contracept. Fertil. Sex. 1995; 23: S61.
  9. Cicinelli E., de Ziegler D. Transvaginal progesterone: evidence for a new functional «portal system» flowing from the vagina to the uterus. Hum. Reprod. Update. 1999; 5:365- 372.
  10. Cicinelli E., de Ziegler D., Buletti C. et al. Direct vagina to uterus transport of progesterone. Obstet Gynecol. 1999; 6:357-361.
  11. Devroey P., Pados G. Preparation of endometrium for egg donation. Hum. Reprod. Update. 1998; 4(6): 856-861.
  12. De Ziegler D., Buletti C., de Moustier B. Endometrial Preparation. In: Principles of oocyte and embryo donation. New York, 1998. Pp.65-76.
  13. Edwards R.G. Implantation, interception and contraception. Hum. Reprod. 1994; 9: 985-995.
  14. Fanchin R., de Ziegler D., Bergeron C. et al. Transvaginal administration of progesterone. Obstet. Gynecol. 1997; 90(3): 396-401.
  15. Friedler S., Raziel A., Schachter M. et al. Characteristics of conceptional and nonconceptional cycles after IVF using micronised progesteron for luteal support: a comparative study of vaginal or oral administration. Human. Reprod. 1998; 13: 161
  16. Gibbons W.E., Toner J. P, Hamacher P. et al. Experience with a novel vaginal progesterone preparation in a donor oocyte programme. Fertil. Steril. 1998; 69(1): 96-101.
  17. Hu Y., Maxson W.S., Hoffman D.I., Ory S.J., Eager S., Dupre J., Lu C. Maximizing pregnancy rates and limiting higher-order multiple conceptions by determining the optimal number of embryos to transfer based on quality. Fertil. Steril. 1998; 69:650-657.
  18. Kornilov N.V., Shlykova S.A., Loginova J.A. et al. Effects of exogenic 17b-oestradiol on IVF outcome. Abstracts of the 15th Annual Meeting of the European Society of Human Reproduction and Embryology. Tours, France, 26-30 June 1999, p.28.
  19. Levy T., Gurevitch S., Bar-Hava I. et al. Pharmacokinetics of natural progesterone administered in the form of a vaginal tablet. Hum. Reprod. 1999: 14(3): 606-610.
  20. Lightman A., Kol S., Itskovitz-Eldor J. A prospective randomized study comparing intramuscular with intravaginal natural progesterone in programmed thaw cycles. Hum. Reprod. 1999; 14(10): 2596-2599.
  21. Lutjen P., Trounson A., Leeton J. et al. The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure. Nature, 1984; 307:174-175.
  22. Miles R.A., Paulson P.J., Lobo R.A. et al. Pharmacokinetics and endometrial tissue levels of progesterone after administration by intramuscular and vaginal routes: a comparative study. Fertil. Steril. 1994; 62(3): 485-490.
  23. Navot D., Anderson T.L., Droech K., et al. Hormonal manipulation of endometrial maturation. J. Clin. Endocrinol. Metab. 1989; 68:801-807.
  24. Navot D., Drews M.R., Bergh P.A. et al. Age-related decline in female fertility is not due to diminished capacity of the uterus to sustain embryo implantation. Fertil. Steril. 1994; 61:97-101.
  25. Nikas G., Develioglu O.H. Toner J.P., et al. Endometrial pinopodes indicate a shift in the window of receptivity in IVF cycles. Hum. Reprod. 1999; 14(3): 787-792.
  26. Noyes N., Lui H.C., Sultan K, et al. Endometrial thickness appears to be a significant factor in embryo transplantation in an vitro fertilization. Hum. Reprod. 1995; 10:919-922.
  27. Oliveira J.B.A., Baruffi R.L.R., Mauri A.L. et al. Endometrial ultrasonography as a predictor of pregnancy in an invitro fertilization programme after ovarian stimulation and gonadotrophinreleasing hormone and gonadotrophins. Hum. Reprod. 1997; 12(11): 2515-2518.
  28. Potter D.A., Witz C.A., Burns W.A. et al. Endometrial biopsy during hormone replacement cycle in donor oocyte recipients before in vitro fertilizationembryo transfer. Fertil. Steril. 1998; 70(2): 219-221.
  29. Pouly J.L, Bassil S., Frydman R., et al. Luteal support after invitro fertilization: Crinone 8%, a sustained release vaginal progesterone gel, versus Utrogestan, an oral micronized progesterone. Hum. Reprod. 1996; 11: 2085-2089.
  30. Prapas Y., Prapas N., Jones E.E. et al. The window for embryo transfer in oocyte donation cycles depends on the duration of progesterone therapy. Hum. Reprod. 1998: 13(3): 720-723.
  31. Sathanandan M., Macnamee M.C., Rainsbury P et al. Replacement of frozen-thawed embryos in artificial and natural cycles: a prospective semirandomized study. Hum. Reprod. 1991; 6: 685-687.
  32. Schoolcraft W.B., Hesla J.S., Gee M. et al. In a highly successeful IVF program, progesteron administered from single daily IM injaction or vaginal progesterone gel applications is equally effective at providing luteal support. Presented at the 55th Annual Meeting of the American Society for Reproductive Medicine; Sept. 25-30, 1999; Toronto, Canada, Abstract.
  33. Simon A., Robinson D.E., Andrews C. M. The absorption of oral micron ised progesteron: the effect of food, dose proportionality, and comparison with intramuscular progesterone. Fertil. Steril. 1993; 60; 26-33.
  34. Simon A., Hurwitz A., Pharhat M. et al. A flexible protocop for artificial preparation on the endometrium without prior gonadotrophin-releasing hormone against suppression in women with functionung ovaries undergoing frozen-thawed embryo transfer cycles. Fertil. Steril. 1999; 71(4): 609-613.
  35. Simon A., Hurwitz A., Zentner B., et al. Transfer of frozen-thawed embryos in artificially prepared cycles with and without prior gonadotrophin-releasing hormone agonist suppression - a prospective randomized srudy. Hum. Reprod. 1998; 13:2712-2717.
  36. Simon C., Landeras J., Zuzuarregui J.L. et al. Early pregnancy losses in in vitro fertilization and oocyte donation. Fertil. Steril. 1999; 72(6): 1161-5.
  37. Toner J.P. Once-a-day dosing with vaginal P4 gel in donor egg cycles. Presented at the 54th Annual Meeting of the American Society for Reproductive Medicine: October4-9, 1998. San- Francisco, California.
  38. Toner J.P., Gibbons W.E. Crinone 8% used once a day for replacement in donor egg recipients: a status report. Fertil. Steril. 1998; 70(suppl.): S336. Abstract P 666.

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