不孕患者接受促排卵治疗后子宫内膜容受性超声特征及对妊娠的预测价值

Ultrasonic Characteristics of Endometrial Receptivity in Infertile Patients After Ovulation Induction Therapy and Its Predictive Value for Pregnancy

目的 探究不孕患者接受促排卵治疗后子宫内膜容受性超声特征及对妊娠的预测价值。方法 选取2018年1月至2019年1月河南省人民医院收治的120例接受促排卵治疗的不孕患者,按照妊娠结局分为妊娠组和未妊娠组,分析两组子宫内膜受容性超声检查特征及对妊娠结果的预测价值。结果 120例不孕患者促排卵治疗后37例(30.8%)妊娠。妊娠组成熟卵泡的雌二醇(E_(2))水平低于未妊娠组,差异有统计学意义(P<0.05);妊娠组内膜厚度高于未妊娠组,动脉阻力指数(RI)、搏动指数(PI)低于未妊娠组,差异有统计学意义(P<0.05);两组血流能量多普勒血流显像(PDI)分型和子宫内膜类型分布比较,差异有统计学意义(P<0.05);子宫内膜厚度、RI和PI预测妊娠结局的曲线下面积(AUC)分别为0.735、0.816、0.838。结论 阴道超声获取的子宫内膜厚度越大,RI、PI越小,子宫内膜容受性越好,其中RI、PI能为预测患者妊娠结局提供可靠参考。

Objective To investigate ultrasonic characteristics of endometrial receptivity in infertile patients after ovulation induction therapy and its predictive value for pregnancy.Methods A total of 120 infertile patients who received ovulation induction treatment in Henan Provincial People’s Hospital from January 2018 to January 2019 were enrolled,and they were divided into pregnancy group and non-pregnant group by pregnancy outcome.The characteristics of endometrial receptivity ultrasound examination and its predictive value for pregnancy outcome in two groups were analyzed.Results Among 120 infertile patients,37cases(30.8%)were pregnant after ovulation induction treatment.The level of estradiol(E 2)in mature follicles of pregnant group was lower than that of non-pregnant group(P<0.05).The intima thickness of the pregnant group was higher than that of the non-pregnant group,while the levels of pulsatility index(PI)and arterial resistance index(RI)were lower than that of the non-pregnant group(P<0.05).The difference of blood flow power doppler imaging(PDI)typing and endometrial type distribution between the two groups was statistically significant(P<0.05).The area under the curve(AUC)of endometrial thickness,arterial RI and PI in terms of pregnancy outcome prediction were 0.735,0.816,and 0.838,respectively.Conclusion The greater the endometrial thickness by vaginal ultrasound,the smaller the RI and PI,and the better the endometrial receptivity.RI and PI can provide a reliable reference for predicting the pregnancy outcome.