阴道三维超声对体外受精-胚胎移植患者子宫内膜容受性及妊娠结局的预测价值

Value of Three-dimensional Transvaginal Sonography in Predicting Endometrial Receptivityand Pregnancy Outcome in Patients Undergoing In Vitro Fertilization-embryo Transfer

目的探究阴道三维超声(3D-TVS)对体外受精-胚胎移植(IVF-ET)患者子宫内膜容受性(ER)及妊娠结局的预测价值。方法选择2021年4月-2022年6月于赣州市人民医院行IVF-ET治疗的100例女性为研究对象,依据其妊娠结局分为妊娠组61例与非妊娠组39例。采用3D-TVS检测其子宫内膜容受性,比较两组子宫内膜形态参数(子宫内膜厚度、子宫内膜容积、子宫内膜类型)与子宫内膜血流参数[血流指数(FI)、血管化指数(VI)、血管-血流指数(VFI)、血流阻力指数(RI)、搏动指数(PI)],采用多因素Logistic回归分析IVF-ET患者妊娠结局的独立影响因素,ROC曲线分析3D-TVS参数对IVF-ET患者妊娠结局的预测价值。结果妊娠组与非妊娠组的子宫内膜形态参数(子宫内膜厚度、子宫内膜容积、子宫内膜类型)比较,差异无统计学意义(P>0.05),但两组子宫内膜血流参数(FI、VI、VFI、RI、PI)比较,差异有统计学意义(P<0.05);多因素Logistic分析显示,FI、VI、VFI、RI、PI是IVF-ET患者妊娠结局的独立影响因素(P<0.05);ROC曲线分析显示,3D-TVS参数预测IVF-ET患者妊娠结局的AUC值由高至低依次为VFI>FI>PI>RI>VI(P<0.05)。结论3D-TVS可完整评估IVF-ET患者的子宫内膜容受性,其子宫内膜血流参数对IVF-ET妊娠结局具有良好的预测价值。

Objective To investigate the predictive value of three-dimensional transvaginal sonography(3D-TVS)on endometrial receptivity(ER)and pregnancy outcome in patients with in vitro fertilization embryo transfer(IVF-ET).Methods A total of 100 women who underwent IVF-ET treatment in Ganzhou People's Hospital from April 2021 to June 2022 were selected as the research objects.According to their pregnancy outcomes,they were divided into pregnancy group(61 women)and non-pregnancy group(39 women).Endometrial receptivity was detected by 3D-TVS.The endometrial morphological parameters(endometrial thickness,endometrial volume,endometrial type)and endometrial blood flow parameters[blood flow index(FI),vascularization index(VI),vascular-blood flow index(VFI),blood flow resistance index(RI),pulsatility index(PI)]were compared between the two groups.Multivariate logistic regression was used to analyze the independent influencing factors of pregnancy outcome in IVF-ET patients.ROC curve was used to analyze the predictive value of 3D-TVS parameters on pregnancy outcome in IVF-ET patients.Results There was no significant difference in endometrial morphological parameters(endometrial thickness,endometrial volume,endometrial type)between the pregnancy group and the non-pregnancy group(P>0.05),but there was significant difference in endometrial blood flow parameters(FI,VI,VFI,RI,PI)between the two groups(P<0.05).Multivariate Logistic analysis showed that FI,VI,VFI,RI and PI were independent influencing factors of pregnancy outcome in IVF-ET patients(P<0.05).ROC curve analysis showed that the AUC value of 3D-TVS parameters in predicting pregnancy outcome of IVF-ET patients was VFI>FI>PI>RI>VI(P<0.05).Conclusion 3D-TVS can completely evaluate the endometrial receptivity of IVF-ET patients,and its endometrial blood flow parameters have good predictive value for IVF-ET pregnancy outcome.