优良胚胎移植后早期妊娠不同结局中3DU-PDA参数的比较

Comparison the endometrial parameters by three-dimensional ultrasonography and power Doppler angiography on HCG administration day between on-going pregnant women and patients suffering early spontaneous abortion after good quality embryos trasnfer.

目的探讨绒毛膜促性腺激素(HCG)注射日(HCG日)子宫内膜三维超声能量多普勒血管成像(three-di-mensional ultrasonography and power Doppler angiography,3DU-PDA)参数与优良胚胎移植后持续妊娠及早期自然流产的关系。方法选择南方医院生殖医学中心2008年8月至2009年1月行黄体中期长方案体外受精(IVF)并经优良胚胎移植(ET)后127例宫内妊娠的妇女为研究对象,根据妊娠维持情况分为A组(ET后持续妊娠≥10周)112例和B组(ET后10周内发生自然流产)15例,分析比较两组一般情况、临床资料和HCG日内膜3DU-PDA的参数。结果A组重组促性腺激素(rFSH)总用量、HCG日血清雌二醇(E2)浓度和着床率均高于B组,差异有统计学意义(P<0.05);A组内膜血管指数(VI)、血流指数(FI)和血管血流指数(VFI)明显高于B组,差异有统计学意义(P<0.05)。结论HCG日子宫内膜3DU-PDA参数VI、FI、VFI可能有助于预测优良胚胎移植后的种植率和妊娠维持情况。

Objective To explore the possible relationship between three-dimensional ultrasonography and power Doppler angiography （3DU-PDA） parameters of endometrium on HCG administration day and on-going pregnancies or early spontaneous abortions after good quality embryos transfer （ET）. Methods A total of 127 patients obtaining normal pregnancy after IVF and good quality embryos transfer treatment were enrolled in the study. All subjects had ovarian stimulation according to a mid-luteal phase long protocol and were divided into two groups according to their early pregnancy outcome： Group A （112 cases） , whose pregnancies continued beyond 10 weeks after ET and Group B （15 cases） , who experienced early spontaneous abortions within 10 weeks after ET. Data analysis was carried out on the patients＇characteristics, clinical information and first trimester pregnancy outcome. Results The total recombinant follitropin doses, serum oestradiol level on HCG administration day and implantation rates were significantly higer in Group A, comparing with Group B （ P 〈 0.05 ）. The endometrial vascularization index, flow index and vascularization flow index were significantly higher for Group A （ P 〈 0.05 ）. Conclusion 3 DU-PDA may serve as an easy, safe and effective way for evaluating uterine receptivity and predict implantation rates as well as on-going pregnancy after good quality embryos transfer.