子宫内膜区动脉血流信号检测的临床价值

Clinical value of arterial blood flow signals in endometrial area in outcomes of freeze-thawed embryo transfer

目的分析子宫内膜区动脉血流信号数与冻融胚胎移植(freeze-thawed embryo transfer,FET)结局的临床价值。方法回顾性分析2015年10月至2017年3月于我中心行FET术并于子宫内膜厚度≥7 mm时经彩色多普勒超声检测子宫内膜区动脉血流信号数的周期175例。按子宫内膜区动脉血流信号数<2、2~5、≥6支将所有病例分为3组,分析3组患者FET胚胎种植率、生化妊娠率、临床妊娠率、异位妊娠率及早期流产率等指标。结果子宫内膜区动脉血流信号数<2支组患者胚胎种植率及临床妊娠率显著低于2~5支组及≥6支组(P<0.05),2~5支组及≥6支组比较差异无统计学意义(P>0.05);3组间生化妊娠率和早期流产率差异无统计学意义(P>0.05)。Logistic回归分析结果显示,子宫内膜区动脉血流信号数与临床妊娠相关,分组比较OR值分别为(4.33,4.70),95%CI分别为[(1.24,15.19),(1.21,18.28)],P<0.05。结论子宫内膜区动脉血流信号数越少,胚胎种植率及临床妊娠率越低。

Objective To analyze the clinical value of arterial blood flow signals in the endometrial area in the outcomes of freeze-thawed embryo transfer(FET).Methods A total of 175 FET cycles in our special hospital from October 2015 to March 2017 were retrospectively analyzed,and the endometrial areas when endometrial thickness over 7 mm were detected the endometrial arterial blood flow signals with color Doppler ultrasonography.The cases were divided into 3 groups according to the numbers of endometrial arterial blood flow signals<2,2~5,and≥6.Pregnancy outcomes,such as embryo implantation rate,biochemical pregnancy rate,clinical pregnancy rate,ectopic pregnancy rate and early abortion rate were followed up in all the cases.Results The embryo implantation rate and clinical pregnancy rate were statistically lower in those with the number of endometrial arterial blood flow signals<2 than those with that of 2~5 and≥6(P<0.05),but no such difference were seen between the 2 latter groups(P>0.05).There were no significant differences in biochemical pregnancy rate and early abortion rate among the 3 groups(P>0.05).Logistic regression analysis showed that the number of endometrial arterial blood signals were correlated with clinical pregnancy in those with the number of signals 2~5 and≥6(OR=4.33,95%CI:1.24~15.19;OR=4.70,95%CI:1.21~18.28,P<0.05).Conclusion The fewer arterial blood flow signals in the endometrial area are,the lower embryo implantation rate and clinical pregnancy rate.