子宫内膜厚度及类型与体外受精-胚胎移植临床结局相关性研究

The correlation between endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer

目的探讨HCG日子宫内膜厚度及类型对体外受精-胚胎移植(IVF-ET)临床结局的相关性。方法回顾性分析行体外受精-胚胎移植助孕1218例患者,HCG日经阴道超声进行子宫内膜厚度、子宫内膜类型测量。子宫内膜厚度分为3组:分别是<8mm组(168周期)、8-11mm组(694周期)、>11mm组(356周期);根据内膜回声类型分成A型、B型、C型,比较不同子宫内膜厚度组及子宫内膜类型的临床结局。结果胚胎移植1218例,临床妊娠率为45.32%,活产率为37.27%。三组不同子宫内膜厚度的妊娠率分别为38.10%、44.81%及49.72%,有显著性差异(P<0.05),但活产率无统计学差异(P>0.05)。子宫内膜厚度与临床妊娠率呈正相关性(r=0.852,P=0.03)。ROC曲线下面积为0.54,显示子宫内膜厚度不是预测妊娠的准确指标。三组不同子宫内膜类型的妊娠率(分别为50.43%、44.80%、41.96%)、着床率及活胎分娩率无显著性差异(P>0.05)。结论 1.HCG日子宫内膜厚度与IVF-ET临床妊娠率呈正相关性,但尚不能用HCG日子宫内膜厚度-作为预测妊娠的判断指标。2.HCG日子宫内膜的类型不影响IVF-ET临床结局。

Objective： To evaluate the relationship between endometrial thickness and pattern on day of human chorionic gonadotrophin（hCG） administration and clinical outcome in patients undergoing in vitro fertlization and embryo transfer（IVF-ET） cycles.Methods：A retrospective study of 1218 IVF-ET cycles,endometrial thickness and pattern were measured by transvaginal ultrasonod on the day of hCG administration.According to endometrial thickness,1218 cycles were sorted into 3 groups：endometrial thickness8mm（n 168）,endometrial thickness 8-11mm（n 694）,endometrial thickness11mm（n 356）.Endometrial pattern were divided into 3 groups： A-type,B-type,C-type.Clinical outcome in different groups were analyzed.Results： A total of 1218 cycles were analysed.Clinical pregnancy rate was 45.32%,and live birth rate was 37.27%.In 3 endometrial thickness groups,clinical pregnancy rate was 38.10%,44.81% and 49.72% respectively,the differences were statistically significant（P0.05） between groups.The live birth rate was not significantly（P0.05）.Endometrial thickness was positively correlated with clinical pregnancy rate（r=0.852,P=0.03）.ROC with an area under the curve（AUC）= 0.54,ROC showed that endometrial thickness is not a good predictor of clinical pregnancy.There were no difference in clinical pregnancy rates between the patterns（50.43% in pattern A,44.80% in pattern B and 41.96% in pattern C,P 0.05）.There was no difference in implantation rate and live birth rate（P0.05）.Conclusion： 1.There is a positive linear relationship between the endometrial thickness measured on the day of hCG injection and clinical pregnancy rate.But endometrial thickness is not a good predictor of clinical pregnancy rate.2.Endometrial patterns hasn′t effert on the outcome in patients undergoing IVF-ET.