体外受精-胚胎移植中卵泡血流参数与妊娠结局的关系

Relationship Between Follicle Blood Flow and Outcome of in Vitro Fertilization-Embryo Pregnancy

目的:探讨体外受精-胚胎移植(IVF-ET)周期中卵泡周围血流与卵泡生长发育、卵母细胞成熟、受精、卵裂、胚胎质量及妊娠结局的关系。方法:对接受体外授精(IVF)或卵细胞胞质内精子注射技术(ICSI)治疗的66个周期(女性输卵管因素58个周期;男性因素8个周期)患者,在注射人绒毛膜促性腺激素(HCG)日行经阴道彩色多普勒超声测量双侧卵巢内每一个直径≥12mm的卵泡周围血流参数。结果:①66个周期中,妊娠26例(39.4%),未妊娠组卵泡周围血流阻力指数(RI)、收缩期峰流速/动脉舒张末期血流速度(S/D)值比妊娠组显著升高(P<0.004)。②当RI<0.49时妊娠率、受精率、卵裂率、MⅡ卵细胞数均显著升高(P<0.05),而Gn用量、周期第次、不育年限、年龄、注射HCG日雌二醇(E2)浓度、获卵数、优质胚胎率差异无统计学意义(P>0.05)。③卵泡血流动脉S与D在妊娠组与未妊娠组中差异无统计学意义(P>0.05)。④线性回归分析卵泡动脉RI与卵泡直径无相关性。结论:卵泡动脉RI是预测IVF-ET妊娠结局的有效指标。

Objective： To study the relationship between perifollicular blood flow and follicle development, oocyte maturing rate, fertilizing rate, cleavaging rate, embryo quality and the outcomes of embryo transfer in vitro fertilization （IVF-ET）. Methods： The samples were selected from 66 suffers who underwent IVF or ICSI. Every perifollicular blood flow （diameter≥12 mm ） was estimated on the day of HCG administration. Results： Among 66 cycles,26 （39. 4%） cycles resulted in pregnancy. Perifollicular blood flow RI and S/D of non-pregnant group was significantly higher than that of the pregnant group （both P〈0.01）. When RI〈0.49, the pregnancy rates, fecundation rates, fertilization rates, numbers of metaphase of second meiosis oocytes increased evidently （all P〈0.05） ,but no statistical difference was found between different RI groups in gonadotropin dosage, cycle frequency, infertility years, ages, E2 on the day of HCG administration and numbers of oocyet retrieved and high-quality embryo rates （all P〉0.05）. Also no statistical difference was found between non-pregnant group and pregnant group in S and D velocity （P〈0.05）.There was no correlation between perifollicular blood flow RI and follicular diameter by linear re gression analysis. Conclusion： Perifollicular blood flow RI and S/D are effective indices of predic ting the pregnancy outcome of IVF-ET.