ABSTRACT
OBJECTIVE： To provide reference for rational use of estradiol （E2） preparation in clinic. METHODS： The medical records of outpatients receiving assisted reproductive technology （ART） and E2 preparation [Estradiol valerate tablets （EV）， Complex packing estradiol tablets/estradiol and dydrogesterone tablets （EP）， Estradiol gel （EG）] were collected from the reproductive medicine center of a hospital during Jan. 2016-Mar. 2017. Taking drug instruction as standard， the rationality of medical records was evaluated from aspects of indication， route of administration， contraindication， usage and dosage， treatment course， etc. At the same time， these patients were followed up by telephone or outpatient service， and their pregnancy outcomes and ADR were summarized. RESULTS： A total of 12 646 prescriptions were collected， and 7 222， 3 912， 181 and 1 331 prescriptions used EV， EP， EG and EV+EP， respectively. The types of off-label use included over-indication， over-route and over-contraindication， and the rates of off-label use rates were 100％， 11.73％ and 43.60％， respectively. A total of 5 868 ART patients were involved； 439 patients received fresh embryo transplantation， and 5 429 patients received frozen-thawed embryo transplantation， involving 720 and 11 926 prescriptions， respectively. The rates of off-label use of above E2 preparations were 100％ （except for fresh embryo transplantation patients using EG）. As of Feb. 2018， the infant-holding rates of ART patients using EV， EP， EG and EV+EP were 85.29％， 85.37％， 86.36％ and 85.45％， respectively. No relevant ADR and neonatal birth defect was found. CONCLUSIONS： The phenomenon of off-label use of E2 preparations is widespread in the reproductive medicine center of the hospital. Although there is no indication of related safety risks， evidence-based evaluation should be carried out by enlarging the sample size in clinical practice， and careful use.
ABSTRACT
Objective To compare perinatal outcomes of the singleton and twin pregnancies , and explore risk factors associated with twin pregnancies. Methods The data of 1 026 patients in single and twin pregnancies treated with IVF/ICSI between January 2014 to March 2015 were retrospectively analyzed. Results The early miscarriage rate and early pregnancy loss rate in the singleton group was significantly higher than the twin group (16% vs 5.41%; 16% vs 6.98%) and the late abortion rate in the singleton group was significantly lower than the twin group (1.93% vs 7.12%), but the total pregnancy loss rate was not significantly different between the groups. The premature delivery rate in the twin group was significantly increased (9.19% vs 41.89%), the term taking-baby-home rate was significantly lower (56% vs 37.89%), but the total taking-baby-home rate was significantly higher in the twin group than the singleton group. The low weight delivery rate in the twin group was significantly increased (1.2% vs 14.8%), but the rate of birth defects was no significantly different between the groups. There were significant differences in age and number of embryo transfer between the two groups. Conclusions Twin pregnancies may increase the risk of late abortion and premature delivery and low weight delivery significantly. Age and number of embryo transfer may be the risk factors for twin pregnancies.