彩色多普勒超声评价体外受精-胚胎移植中卵巢反应性的应用

Assessment of ovarian response with color Doppler ultrasonography in vitro fertilization-embryo transfer

目的探讨体外受精-胚胎移植周期中卵巢反应性与卵巢基质和卵泡血供的关系。方法42例女性，长周期方案促排卵，根据右侧卵巢内收集的卵母细胞数目分为低反应卵巢组（1～3个）、正常反应卵巢组（4～8个）、高反应卵巢组（8个以上），于绒毛膜促性腺激素注射日采用经阴道彩色多普勒超声记录检测侧卵巢基质内动脉收缩期峰值流速（PSV）、舒张末期流速（EDV）、搏动指数（PI）、阻力指数（RI）、收缩期与舒张末期流速比值（S／D），并对卵泡周边血流分布分级评分。结果低反应卵巢组卵巢基质内动脉PSV、EDV较正常和高反应卵巢组降低，卵泡周边血流分布也减少，卵巢基质内血流PSV、EDV和卵泡周血流分布与卵巢的反应性具有正相关关系。结论卵巢基质内血流PSV、EDV增高，卵泡周边血流分布增加，改善了卵巢内血流灌注，可提高卵巢的反应性。

Objective To investigate the relationship between ovarian response and blood supply in ovarian stroma and follicle during in vitro fertilization-embryo transfer cycle. Methods After long-cycle controlled ovarian hyperstimulation, 42 women were divided into poor-response （1 -3 oocytes）, normalresponse （4-8 oocytes） and high-response groups （〉8 oocytes） according to the number of oocytes collected in one ovary. On day of human chorionic gonadotrophin injection, PSV, EDV, PI, RI, S/D of ovarian stromal artery in the ovarian were detected and perifollicular vascularity were graded with color Doppler ultrasonography. Results Not only PSV and EDV of stromal artery but also perifollicular vascularity in low-response group was significantly lower than that of normal-response and high-response groups. PSV and EDV of ovarian stromal artery and perifollicular vascularity were highly interrelated with ovarian response. Conclusions The increase of PSV and EDV of ovarian stromal artery and perifollicular vascilarity indicate the improvement of perfusion in ovary and ovarian response.