彩色多普勒超声检查预测冻融胚胎解冻移植妊娠结局的价值
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摘要
目的探讨彩色多普勒超声检查测定子宫内膜厚度、形态、内膜及动脉血流,评价子宫内膜容受性及预测冻融胚胎解冻移植(FET)妊娠结局的价值。方法选择2018年1-7月在该院生殖医学中心接受FET的患者作为研究对象,共209个周期,采用彩色多普勒超声在移植当天测量子宫内膜厚度、形态、内膜及动脉血流,根据临床妊娠与否分为妊娠组(n=105)和未妊娠组(n=104),比较上述指标在两组间有无差异。结果未妊娠组与妊娠组子宫内膜厚度比较,差异无统计学意义(P>0.05);未妊娠组与妊娠组子宫内膜形态分型比较,差异有统计学意义(P<0.05);未妊娠组与妊娠组子宫内膜血流分型比较,差异有统计学意义(P<0.05);未妊娠组子宫内膜血流的搏动指数(PI)、阻力指数(RI)、舒张期与收缩期血流速度比值(S/D)分别为1.15±0.13、0.62±0.06、2.88±0.19,明显高于妊娠组的0.91±0.09、0.56±0.03、2.24±0.19,差异均有统计学意义(P<0.05);未妊娠组与妊娠组子宫动脉血流的PI、RI、S/D比较,差异均无统计学意义(P>0.05)。结论彩色多普勒超声检查子宫内膜情况对预测FET妊娠结局有一定价值。
Objective To discuss the value of color Doppler ultrasound detection in measuring the endometrial thickness,endometrial pattern,endometrial and uterine artery blood flows in the evaluation of endometrial receptivity and prediction of freeze-thaw embryo thawing transfer(FET)pregnancy outcome.Methods The patients received FET from January 2018 to July 2018 in the Reproductive Medicine Center of the Second Affiliated Hospital of Chongqing Medical University were selected as the research objects,and 209 cycles were conducted.The endometrial thickness,morphology,endometrial and arterial blood flow were measured by color Doppler ultrasound on the day of transplantation.According to the clinical pregnancy,they were divided into pregnancy group(n=105)and non-pregnancy group(n=104).The differences of the above indicators between the two groups were compared.Results There was no statistically significant difference between the non-pregnancy group and the pregnancy group in endometrial thickness(P>0.05).The endometrial pattern had statistically significant difference between the two groups(P<0.05).The endometrial blood flows had statistically significant difference between the two groups(P<0.05).In the non-pregnancy group,the pulse index(PI),resistance index(RI),ratio of diastolic to systolic blood flow velocity(S/D)of endometrial blood flows were 1.15±0.13,0.62±0.06,2.88±0.19,respectively,and were significantly higher than those in the pregnancy group,which were 0.91±0.09,0.56±0.03,2.24±0.19,and the differences were statistically significant(P<0.05).The PI,RI and S/D of uterine artery blood flows had no statistically significant difference between the non-pregnancy group and the pregnancy group(P>0.05).Conclusion Detecting the endometrial pattern and endometrial blood flows by color Doppler ultrasound can evaluate endometrial receptivity and has agood predictive value for FET pregnancy outcomes.
Objective To discuss the value of color Doppler ultrasound detection in measuring the endometrial thickness,endometrial pattern,endometrial and uterine artery blood flows in the evaluation of endometrial receptivity and prediction of freeze-thaw embryo thawing transfer(FET)pregnancy outcome.Methods The patients received FET from January 2018 to July 2018 in the Reproductive Medicine Center of the Second Affiliated Hospital of Chongqing Medical University were selected as the research objects,and 209 cycles were conducted.The endometrial thickness,morphology,endometrial and arterial blood flow were measured by color Doppler ultrasound on the day of transplantation.According to the clinical pregnancy,they were divided into pregnancy group(n=105)and non-pregnancy group(n=104).The differences of the above indicators between the two groups were compared.Results There was no statistically significant difference between the non-pregnancy group and the pregnancy group in endometrial thickness(P>0.05).The endometrial pattern had statistically significant difference between the two groups(P<0.05).The endometrial blood flows had statistically significant difference between the two groups(P<0.05).In the non-pregnancy group,the pulse index(PI),resistance index(RI),ratio of diastolic to systolic blood flow velocity(S/D)of endometrial blood flows were 1.15±0.13,0.62±0.06,2.88±0.19,respectively,and were significantly higher than those in the pregnancy group,which were 0.91±0.09,0.56±0.03,2.24±0.19,and the differences were statistically significant(P<0.05).The PI,RI and S/D of uterine artery blood flows had no statistically significant difference between the non-pregnancy group and the pregnancy group(P>0.05).Conclusion Detecting the endometrial pattern and endometrial blood flows by color Doppler ultrasound can evaluate endometrial receptivity and has agood predictive value for FET pregnancy outcomes.
引文
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[8]田密苏,郑波,吕芳杰.彩色多普勒能量超声评估子宫内膜容受性预测胚胎解冻移植妊娠结局的价值[J].宁夏医科大学学报,2016,38(9):1058-1060.
[9]王锦惠,于子芳,闫芳,等.经阴道二维及三维超声对体外受精-胚胎移植子宫内膜容受性的评估价值[J/CD].中华医学超声杂志(电子版),2015,12(4):319-324.
[10]李华,李蓉,王丽娜,等.西地那非改善反复移植失败患者子宫内膜血流的研究[J].中国妇产科临床杂志,2015,16(2):115-118.
[11]李华,李蓉,刘洋,等.芬吗通改善反复胚胎移植失败患者子宫内膜血流和提高妊娠率的研究[J].生殖医学杂志,2014,23(1):37-41.
[2] CHEN Z J,SHI Y,SUN Y,et al.Fresh versus frozen embryos for infertility in the polycystic ovary syndrome[J].N Engl J Med,2016,375(6):523-533.
[3] KHAN M S,SHAIKH A,RATNANI R.Ultrasonography and doppler study to predict uterine receptivity in infertile patients undergoing embryo transfer[J].J Obstet Gynaecol India,2016,66(Suppl 1):S377-382.
[4] ARCE H,VELILLA E,LPEZ-TEIJN M.Association between endometrial thickness in oocyte donation cycles and pregnancy success rates[J].Reprod Fertil Dev,2015,28(9):1288-1294.
[5]唐志霞,洪名云,张玲,等.子宫动脉及子宫内膜血流对体外受精-胚胎移植结局的影响[J].中国计划生育和妇产科,2015,34(7):15-17.
[6]李江涛,曹金丽,程传生,等.经阴道三维超声在冻融胚胎解冻移植时机选择中的运用价值[J/CD].中华临床医师杂志(电子版),2013,7(9):3782-3785.
[7] KIM A,JUNG H,CHOI W J,et al.Detection of endometrial and subendometrial vasculature on the day of embryo transfer and prediction of pregnancy during fresh in vitro fertilization cycles[J].Taiwan J Obstet Gynecol,2014,53(3):360-365.
[8]田密苏,郑波,吕芳杰.彩色多普勒能量超声评估子宫内膜容受性预测胚胎解冻移植妊娠结局的价值[J].宁夏医科大学学报,2016,38(9):1058-1060.
[9]王锦惠,于子芳,闫芳,等.经阴道二维及三维超声对体外受精-胚胎移植子宫内膜容受性的评估价值[J/CD].中华医学超声杂志(电子版),2015,12(4):319-324.
[10]李华,李蓉,王丽娜,等.西地那非改善反复移植失败患者子宫内膜血流的研究[J].中国妇产科临床杂志,2015,16(2):115-118.
[11]李华,李蓉,刘洋,等.芬吗通改善反复胚胎移植失败患者子宫内膜血流和提高妊娠率的研究[J].生殖医学杂志,2014,23(1):37-41.