Transcription of ARTにおける黄体ホルモン補充 - kinutani.org
1 2016/7/6 in ART 1. 2. 3. ( ) 6. P4 P4 progesterone receptor, PR 1. ART luteal support first pass effect micronized OC, LEP 2. C-21 C-19 17 - , LD/ULD 2 , 82 7 , 734 MPA, 3- 82 7 , 735 10 25 10 25 125 65 125 5 2 5 5 5 5 1 82 7 , 735 ( ) ( )
2 50 1 125 10 2 2 1 1 82 7 , 736 luteal insufficiency, luteal phase defect, luteal phase deficiency, inadequate corpus luteum, luteal phase inadequancy3. 10-30% 25-60% 7 A / , 82 7 , 747 82 7 , 749 31,334 32,676 34,953 38,575 41,619 42,822 44,778 53,873 59,148 63,083 67,714 71,422 82,108 11,653 13,034 15,887 24,459 30,287 35,069 42,171 45,478 60,115 73,927 83.
3 770 95,764 119,089 55,701 60,360 67,672 73,143 83,284 85,859 92,102 112,459 127,081 136,094 153,788 169,169 202,396 050,000100,000150,000200,000200020012002 2003200420052006200720082009201020112012 [ ] 1. 25 2012 2014 7 . 66 9 : 2445-2481, 20142. ~jsog- 2008 [ ] ( )1 Progesterone progesterone 2micronized progesterone progesterone 3micronized progesterone progesterone 4 progesterone progesterone 5hydroxyprogesteronecaproate hydroxyprogesteronecaproate 6 hlormadinoneacetate chlormadinone 7dydrogesterone dydrogesterone 8 medroxyprogesterone medroxyprogesterone 9 norgestrel( )
4 82 7 , 754 2012 in ART 77%17%5% or hCG 94 First uterine pass effect First uterine pass effect Cicinelliet al. Hum reprodUpdate 1999;5(4)365-372 20 Gynecol May;18(5) 32 50 or 50 P4 200 mg/ 1. 6,0002. 4003. 98 g145 1. 98g 2. g 145 ml 2 / 60-65 C 55-65 C 3 ml 1 1 ml 5. 4 C HP 2014 12 2016 2 4 7 GnRH / HMG/FSH D2/D3 D5 P4 EP00< >D2/D3D54w2d 400 mg/ 300 mg/ 7, 8w P4 < ng/mlP4 ng/ml 100 mg/ GnRH D2/D3 D5 P4 P4 P4 400 mg/ EP00< (HRT >D2/D3D54w2d 400 mg/ 300 mg/ 10w R 600mg/day , R 300mg/day.)
5 R 800mg/day 600mg/day 300mg/day 800mg/day P4 3 P4 P4 P4 3 GnRH D2/D3 D5 EPD2/D3D54w2d 600mg/day 300mg/day 800mg/day 10w E2 P4 E2 P4 CGD03 P4 3
