经阴道彩色超声监测卵巢血流动力学变化评价IVF-ET中卵巢反应性和结局

The Value of Transvaginal Color Doppler in the Forecasting the Ovary Response and Pregnancy in vitro Fertilization and Embryo Transfer

目的:探讨监测双侧卵巢血流动力学参数变化在体外受精-胚胎移植(IVF-ET)过程中评价卵巢反应性和妊娠结局的价值。方法:对在本中心进行IVF-ET的97例不孕症妇女,使用经阴道彩色多普勒超声成像技术(TV-CDS)测量控制性超排卵(COH)周期的月经d2、d7、hCG注射日、取卵日、移植日卵巢基质血流的阻力指数(RI)、搏动指数(PI)。根据获卵总数、用药天数、是否妊娠等指标将病人分组后,比较各参数在不同组间的差异。结果:①在COH周期中PI、RI呈下降趋势,但各取样日的差异无统计学意义;②月经d2PI、RI在卵巢高、中、低反应组病人中差异有统计学意义(P<0.01);③卵巢基质血流PI越高,用药天数越长(P<0.05);④PI、RI在妊娠组显著低于非妊娠组;月经d2PI值在0.50-0.75和0.76-0.95的两组病人妊娠率分别为51.6%和19.7%,差异有统计学意义。结论:月经d2卵巢基质血流PI、RI是卵巢反应性和IVF-ET结局的有效预测指标。

Objective： To investigate the value of transvaginal color Doppler in the forecasting the ovary response and pregnancy. Methods： Ninty-seven infertile women were divided according to the number of oocyte collected, days of treatment, pregnancy RI and PI of ovary stromal blood flow were examined by transvaginal color Doppler ultrasound. And then the ovary stromal blood flow parameters were compared among groups. Results： PI and RI were significant different among low, normal, high response groups; the higher of PI, the more of days of treatment; PI and RI in pregnancy group were lower significantly than that in non-pregnancy group; the pregnancy rate were respectively 51.6% and 19.7% when patients were divided into two groups according to the PI. Conclusions： PI and RI of d 2 are valuable to predict the ovary response and pregnancy.