经阴道彩色多普勒超声监测子宫、卵巢血流动力学变化在IVF-ET中应用价值研究

Study on the Application Value of Transvaginal Color Doppler Ultrasound in Monitoring the Hemodynamic Changes of Uterus and Ovary in IVF-ET

目的:探讨经阴道彩色多普勒超声(transvaginal color Doppler sonography,TV-CDS)监测子宫、卵巢血流动力学变化在体外受精-胚胎移植(in vitro fertilizatim and embryo transfer,IVF-ET)中应用价值。方法:选取2018年1月~2020年1月于菏泽市第三人民医院进行IVF-ET不孕症妇女60例为研究组,选取同期于本院进行体检的健康育龄期妇女60例作为对照组,对比两组受试者卵泡、卵巢及内膜厚度以及血流动力学指标的差异。结果:研究组子宫体积较对照组缩小(P<0.05),内膜厚度较对照组更薄(P<0.05),双侧卵巢体积较对照组变小(P<0.05),回声增强且结构相对模糊,皮质内出现未见发育或是小卵泡回声;研究组RI指标较对照组更低(P<0.05),PI指标较对照组更高(P<0.05);研究组不同PI值妊娠率差异显著(P<0.05),PI值0.50~0.75妊娠率更高。结论:采用TV-CDS可清晰将患者卵巢具体形态以及功能状况等反映出来,RI、PI可作为对患者卵巢反应性进行有效预测的指标,可参照以上血流参数来确定最终的用药方案。

Objective:To explore the application value of transvaginal color Doppler ultrasound(TV-CDS)in monitoring uterine and ovarian hemodynamic changes in IVF-ET(in vitro fertilization-embryo transfer).Methods:60 infertile women who underwent IVF-ET in Heze Third People’s Hospital from January 2018 to January 2020 were selected as the study group,and 60 healthy women of childbearing age who underwent physical examination in our hospital at the same time were selected as the control group.The differences of follicular,ovarian,endometrial thickness and hemodynamic indexes between the two groups were compared.Results:The uterine volume of the study group was smaller than that of the control group(P<0.05),the endometrial thickness was thinner than that of the control group(P<0.05),and the bilateral ovarian volume was smaller than that of the control group(P<0.05).The echo was enhanced and the structure was relatively blurry,and no development or small follicle echo appeared in the cortex;The RI index of the study group was lower than that of the control group(P<0.05),and the PI index was higher than that of the control group(P<0.05);There was a significant difference in pregnancy rates among different PI values in the study group(P<0.05),with higher pregnancy rates between PI values of 0.50-0.75.Conclusion:Using TV-CDS can clearly reflect the specific shape and functional status of the patient’s ovary,RI and PI can be used as indicators to effectively predict the patient’s ovarian responsiveness,the above blood flow parameters can be used to determine the final medication regimen.