经阴道超声子宫内膜分型对体外受精-胚胎移植妊娠结局的预测价值

Effect of ultrasound endometrium pattern at the day of hCG administration on clinical outcome in patients undergoing in vitro fertilization and embryo transfer

目的 探讨注射人绒毛膜促性腺激素（hCG）日超声下子宫内膜分型对体外受精-胚胎移植治疗患者妊娠结局的预测价值.方法 回顾性分析在我中心接受体外受精-胚胎移植（IVF-ET）治疗用黄体中期长方案的679例患者共679个周期,根据注射hCG日子宫内膜形态分为3组：A组411例,子宫内膜呈三线征;B组228例,子宫内膜三线征不明显;C组40例,呈均质强回声内膜.比较三组间的胚胎种植率、临床妊娠率、流产率等.结果 A、B、C组胚胎种植率分别为27.05％、20.33％、19.57％,临床妊娠率分别为34.31％、25.00％、12.50％,A组的胚胎种植率、临床妊娠率均高于其余两组,差异有统计学意义（P＜0.05）;三组流产率分别为16.31％、19.30％、40.00％,差异无统计学意义（P＞0.05）.结论 hCG日A型子宫内膜患者较B型、C型内膜的患者更易受孕,超声下子宫内膜分型对体外受精-胚胎移植患者的妊娠结局有一定预测价值.

Objective To investigate the prediction value of ultrasound endometrial pattern at the day of hCG administration on clinical outcome in patients undergoing in vitro fertilization-embryo transfer （IVF-ET）.Methods 679 cycles of IVF-ET conducted between January 2011 and December 2012 in Beijing Obstetrics and Gynecology Hospital were reviewed retrospectively.All cycles were divided into three groups based on the endometrial pattern measured on the hCG day：group A （n =411） with triple line endometrium,group B （n =228） with no obvious triple line endometrium,group C （n =40） with homogeneous hyperechoic endometrium.Clinical outcomes such as implantation rate,pregnancy rate and miscarriage rate were analyzed.Results Among three groups,the implantation rates were 27.05%,20.33%,19.57%,respectively （x2 =9.04,P =0.01）; the pregnancy rates were 34.31%,25.00%,12.50%,respectively （x2 =12.20,P =0.00）.The implantation rate and pregnancy rate in group A were higher than the other two groups （P 〈0.05）.The miscarriage rates were 16.31%,19.30%,40.00%,respectively（P 〉 0.05）,there were no significant difference among them.Conclusions The ultrasound endometrium pattern on the day of hCG administration has predictive value on clinical outcome in patients undergoing in vitro fertilization-embryo transfer.