HCG注射日应用彩色多普勒超声检测子宫内膜和内膜下血流评价IVF-ET结局

Assessment of pregnancy outcomes during in IVF-ET by endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound on the day of HCG injection

目的探讨HCG注射日应用彩色多普勒超声检测子宫内膜和内膜下血流在预测IVF-ET结局中的。方法选取2006年8月～2007年1月在该中心接受IVF-ET/ICSI-ET助孕的54例不孕症妇女,根据HCG注射日应用彩色多普勒超声检测子宫内膜和内膜下血流分布的情况分为A组(n=24):子宫内膜和内膜下均有血流通过;B组(n=19):内膜下有血流但内膜没有血流通过;C组(n=11):内膜和内膜下均无血流通过;随访IVF-ET结局,按妊娠与否分为妊娠组(n=26),胚胎移植后4、5周B超检查宫腔内见妊娠囊及有原始胎心管搏动)与非妊娠组(n=28)。比较A、B、C3组的临床特征、卵巢反应、内膜厚度及类型和妊娠结局。比较妊娠组与非妊娠组内膜厚度和类型。结果A、B、C3组的临床特征、卵巢反应、内膜类型比较差异均无显著性,内膜厚度C组均低于A组(P<0.05)和B组(P<0.05);A、B、C三组妊娠率(66.7%、42.1%和18.2%)和种植率(40.0%、21.1%和9.1%)比较差异有显著性(P<0.05)。妊娠组与非妊娠组的内膜厚度及类型比较均差异无显著性。结论HCG注射日应用彩色多普勒超声检测子宫内膜和内膜下血流对IVF-ET的结局有一定的预测价值,是一种较好的、能在临床上普遍开展的无创伤性的预测方法。

[Objective] To discuss the role of endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound in the prediction of outcomes IVF-ET on the day of HCG injection. [Methods] A total of 54 infertile patients undergoing the IVF/ICST-ET cycle in this center from August 2006 to January 2007 were recruited in this study. The patients were divided into 3 groups according to a color Doppler ultrasound examination performed on the day of HCG injection. Group A （n =24）, both endometrial and subendometrial blood flow could be detected; Group B （n =19）, only subendometrial blood flow could be detected; Group C （n =11）, the blood flow could not be detected. All the patients were divided into two groups according to their outcomes of IVF-ET： Group pregnancy （n =26： intrauterine pregnancy with live fetus after four to five weeks for ET） and Group not pregnancy （n = 28）. Demographic data, ovarian responses, endometrial thickness and echo pattern, outcomes of pregnancy were compared. [Results] Demographic data, ovarian responses, endometrial echo pattern had no significant difference in the three groups, but endometrial thickness was lesser in the Group C than in the Group A （P 〈0.05） and Group B （P 〈0.05）. There was significant difference of the rate of pregnancy and implantation between the three groups. There was no significant difference of endometrial thickness and echo pattern between the pregnancy and not pregnancy group. [Conclusion] Endometrial and subendometrial blood flows is a good predicator of endometrial receptivity and outcomes of IVF-ET on the day of HCG injection, is a good non-invasive method.