子宫内膜容积和内膜下血流对子宫内膜容受性影响的比较

Impacts of endometrial volume and endometrial blood flow on endometrial receptivity

目的探讨子宫内膜容积和子宫内膜下血流情况对子宫内膜容受性的影响。方法应用经阴道二维彩色多普勒及三维容积成像,对138例拟行体外受精一胚胎移植技术(IVF-ET)的不孕症患者于控制性超促排卵周期中移植日进行子宫内膜容积及子宫内膜下螺旋动脉血流搏动指数(PI)、血流阻力指数(RI)进行测量。根据妊娠结果将138例患者分为妊娠组(55例)和非妊娠组(83例),比较两组间相关参数的差异。结果妊娠组子宫内膜容积与非妊娠组比较,无统计学差异(P>0.05);妊娠组子宫内膜下螺旋动脉的PI及RI均低于非妊娠组,两组比较,差异均有显著统计学意义(P<0.01)。子宫内膜容积及内膜下螺旋动脉PI、RI预测妊娠的ROC曲线下面积分别为0.569、0.729、0.717。结论子宫内膜下血流情况在子宫内膜容受性方面起重要的作用,对IVF-ET的妊娠率影响更大。

Objective To compare the impacts of endometrial volume and endometrial blood flow on endometrial receptivity.Methods A total of 138 infertility patients ready to receive in vitro fertilization-embryo transfer （IVF-ET） underwent the measurement of endometrial volume and pulsatility index （PI） and resistance index （RI） of endometrial spiral artery in the controlled ovarian hyperstimulation cycles during the day of transplantation via transvaginal two-dimensional color Doppler and three-dimensional volume imaging.The patients were divided into pregnant group （n =55） and non-pregnant group （n =83）,and the related parameters were compared between them.Results Endometrial volume was of no significant difference between the two group （P ＞ 0.05）.PI and RI of endometrial spiral artery were significantly lower in the pregnant group than in the non-pregnant group （P ＜ 0.01）.The areas under ROC curve of endometrial volu me and endometrial spiral artery PI and RI were 0.569,O.729 and 0.717.Conclusion Endometrial blood plays an important role in terms of endometrial receptivity,and the effect on IVF-ET pregnancy rate is large.