三维超声定量指标对体外受精-胚胎移植中发生卵巢过度刺激综合征的预测价值

Value of three-dimensional ultrasound in predicting ovarian hyperstimulation syndrome in IVF-ET

目的探讨三维超声定量指标评估对体外受精-胚胎移植(in vitro fertilization and embryotransfer,IVF-ET)中发生卵巢过度刺激综合征(ovarian hyperstimulation syndrome,OHSS)的预测价值。方法回顾性分析2016年10月至2018年4月就诊于南京中医药大学附属医院生殖医学科、接受IVF-ET治疗的不孕症患者,将发生OHSS的45例作为观察组,随机选取同期接受治疗但未发生OHSS的45例为对照组。在进行IVF-ET治疗前的早卵泡期,经阴道三维超声监测卵巢定量指标窦卵泡数(antral follicles count,AFC)、卵巢3 D体积(ovarian 3 D volume,OV)、卵巢间质动脉峰值流速(peak systolic velocity,PSV)、卵巢间质动脉血管化指数(vascularization index,VI)、血流指数(flow index,FI)、血管血流指数(vascularization flow index,VFI),并与同期测量的血清抗苗勒管激素(anti-Mullerian hormone,AMH)进行相关分析。结果 OHSS组定量指标AFC、OV、PSV、VI、FI、VFI均高于对照组(P <0. 05)。Pearson相关分析显示,AFC、OV、PSV、VI、FI、VFI与AMH均呈正相关(r值分别为0. 59、0. 51、0. 17、0. 19、0. 18、0. 15)。结论三维超声定量指标对于预测OHSS的发生有一定临床价值。

Objective To explore the predictive value of three-dimensional ultrasound quantitative index in evaluating ovarian hyperstimulation syndrome(OHSS) in in vitro fertilization-embryo transfer(IVF-ET).Methods Retrospective analysis of infertility patients who were treated in the Reproductive Medicine Department of Affiliated Hospital of Nanjing University of Chinese Medicine and received IVF-ET treatment from October 2016 to April 2018.45 patients with OHSS were enrolled in the observation group.45 patients who were treated at the same time but did not have OHSS were selected as the control group.The number of ovarian quantitative indexes(AFC),ovarian 3 D volume(OV),ovarian stromal artery peak systolic velocity(PSV),ovarian interstitial artery vascularization index(VI),blood flow index(FI),vascular blood flow index(VFI) were measured by transvaginal three-dimensional ultrasound in the early follicular phase of the ovarian follicle,and correlation analysis was made with anti Mullerian hormone(AMH).Results The quantitative indexes of AFC,OV,PSV,VI,FI and VFI in OHSS group were higher than those in the control group(P<0.05).Pearson correlation analysis showed that AFC,OV,PSV,VI,FI,VFI and AMH were positively correlated(r = 0.59,0.51,0.17,0.19,0.18,0.15,respectively).Conclusion Three-dimensional ultrasound quantitative indicators have certain clinical value for predicting the occurrence of OHSS.