经阴道超声检测激素替代周期子宫内膜血流参数对胚胎移植妊娠结局的评估价值

Evaluation of endometrial-subendometrial blood flow measured by transvaginal ultrasound in hormone replacement cycle on outcome of embryo transplantation

目的:探讨经阴道超声检测激素替代周期胚胎移植中内膜转化日子宫内膜厚度、子宫内膜血流等参数对妊娠结局的评估价值。方法:选择100例于激素替代周期行冻融胚胎移植的不孕症患者,根据妊娠结果分为妊娠组(n=60)与未妊娠组(n=40)。比较两组子宫内膜转化日的子宫内膜厚度、内膜血流搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)、收缩期峰值流速与舒张末期流速比值(systolic-diastolic ratio,S/D)等参数。结果:两组内膜转化日的雌二醇(estradiol,E2)、黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulation hormone,FSH)水平,优质胚胎数及子宫内膜厚度差异均无统计学意义。与未妊娠组比较,妊娠组内膜PI、RI、S/D等血流动力学参数明显降低(P<0.05)。转化日子宫内膜厚度<8 mm者妊娠率低于子宫内膜厚度≥8 mm者(P<0.05)。妊娠组转化日内膜S/D>3者的比例低于非妊娠组(P<0.05)。结论:经阴道超声检测子宫内膜血流参数,有助于预测激素替代周期胚胎移植的妊娠结局。

Objective:To explore the value of the intrauterine thickness,endometrial-subendometrial blood flow detected by transvaginal ultrasound at endometrial transformation day in the evaluation of pregnancy outcome in infertility patients underwent embryo transplantation in hormone replacement cycle.Methods:The data of 100 patients underwent embryo transplation(ET)with hormone cycle control membrane were retrospectively analyzed.The patients were divided into pregnancy group(n=60)and non-pregnancy group(n=40).The endometrial thickness,endometrial-subendometrial blood flow indexes such as pulsatility index(PI),resistance index(RI),ratio of systolic peak velocity and end-diastolic velocity(S/D)were detected at the day of endometrium transformation.According to the result of pregnancy outcome,all patients were divided into pregnancy group and non-pregnancy group,and the differences in the various parameters between the two groups were compared.Results:There was no significant difference between the levels of estradiol(E2),luteinizing hormone(LH),follicular stimulating hormone(FSH),and the number of high-quality embryos between the two groups at transformation day.There was no significant difference in endometrial thickness between the two groups at transformation day.Compared with the non-pregnancy group,the endometrial-subendometrial hemodynamic parameters such as PI,RI,and S/D in the pregnancy group were significantly reduced at transformation day(P<0.05).The pregnancy rate was significantly lower in patients with endometrial thickness<8 mm than those of endometrial thickness≥8 mm at the transformation day(P<0.05).The proportion of patients with S/D>3 in the pregnancy group was significantly lower than that in the non-pregnancy group at the transformation day(P<0.05).Conclusions:The endometrial thickness,endometrial-subendometrial blood flow detected at endometrial transformation day by transvaginal ultrasound are helpful to predict the outcome of embryo transplantation in hormone replacement cycle.