超促排卵与胚胎着床前期子宫内膜容受性的关系

The Relationship Between Stimulated Cycle and the Endometrial Receptivity on Pre-implantation

目的：探讨体外受精-胚胎移植（IVF—ET）中超促排卵与胚胎着床前期子宫内膜容受性的关系。方法：选择行长方案IVF-ET患者70例，检测自然周期排卵后第3天和超促排卵周期取卵后第3天（即ET日）的子宫内膜厚度和血流状态。按子宫内膜穿支血流显示情况分为3级：I级，内膜穿支血流≤2支；II级，内膜穿支血流为3—5支；Ⅲ级，内膜穿支血流≥6支。随访IVF-ET结局，分为妊娠组（24例）和非妊娠组（46例）。结果：妊娠组自然周期内膜穿支血流情况与未妊娠组间差异有统计意义（P〈0．05），而2组间超促排卵周期内膜穿支血流情况差异无统计意义（P〉0．05）。妊娠组自然周期和超促排卵周期子宫内膜穿支血流情况均较为丰富，差异无统计意义（P〉0．05）；而未妊娠组超促排卵周期子宫内膜穿支血流情况较自然周期丰富，差异有统计意义（P〈0．01）。自然周期和超促排卵周期子宫内膜血流参数和子宫内膜厚度差异均无统计学意义（均P〉0．05）。结论：自然周期内膜穿支血流丰富可能提示较高妊娠率，可作为子宫内膜容受性的参考指标之一。超促排卵可能改变胚胎着床前期子宫内膜容受性，但尚无影响子宫内膜厚度及血流参数的相关证据。

Objective： To investigate the relationship between endometrial blood flow measured by Color Doppler on pre-implantation and in vitro fertilization and embryos transfer cycle （IVF-ET）. Methods： Data were obtained a total 70 women undergoing IVF-ET from May to November 2009. The endometrial thickness, blood flow status were detected by transvaginal ultrasonography on pre-implantation which include the third day after ovulation before IVF-ET cycles and the day of embryos transfer during IVF-ET cycles both. The patients were divided into three groups by the show of endometrial blood flow： I , the number of the endometrial perforating blood flow ≤2 branch; II, the number of the endometrial perforating blood flow 3-5 branch; III, the number of the endometrial perforating blood flow ≥6 branch. Results： In natural cycles, there is significant difference between the endometrial blood status of pregnancy groupand the non-pregancy group that （P 〈0.05 ）, and in stimulated cycles, there is no signtifieally difference （P 〉0.05 ）. There is no significant difference between endometrial blood flow of the third day after natural ovulation and the day of ET as both were plentiful in pregnancy group （P 〉0.05 ）., but in non-pregnancy group the latter is more plentiful significantly than the former （P〈0.01）. The parameters and endometrial thickness in pregnancy group were similar to non-pregnancy group in stimulated cycle and natrual cycle （P 〉0.05 ）. Conclusion： Richer of endometrial perforating blood flow in stimulated cycle have higher pregnancy rate, which can be as forecast level of endometrial receptivity. Stimulated cycle may change the endometrial receptivity, but do not have relevant evidence on the endometrial thickness and the parameters.