种植窗期子宫内膜厚度、类型和宫腔冲洗液中LIF水平与IVF-ET妊娠结局的关系

目的分析种植窗期子宫内膜厚度、类型和宫腔冲洗液中白血病抑制因子（LIF）水平与体外受精胚胎移植（IVF-ET）妊娠结局的关系。方法选择行IVF或ICSI治疗的不孕患者105例,于IVF-ET前1个月经周期排卵后第7～9天,行阴道超声测量子宫内膜的厚度并分型,ELISA法测定宫腔冲洗液中的LIF。结果 105例不孕症患者IVF-ET治疗后,妊娠64例、未妊娠41例,二者年龄、不孕时间、不孕类型差异无统计学意义;妊娠者种植窗期子宫内膜厚度为（11.89±1.63）mm,小于未妊娠者的（13.72±2.39）mm,P〈0.05;子宫内膜厚度7～10、10～13、13～17 mm时,IVF-ET妊娠率分别为40.0%、72.7%、41.4%。本组A、B、C三种类型子宫内膜分别为50、36、19例,其妊娠率分别为70.0%、63.9%、31.6%;其中A型与B、C型比较,P均〈0.05;B、C型比较,P〉0.05。妊娠者宫腔冲洗液中LIF为（41.19±31.02）pg/mL,高于未妊娠者的（23.43±23.09）pg/mL,P〈0.05。结论 IVF-ET前1个月经周期中经阴道超声测定子宫内膜的厚度和类型、检测宫腔冲洗液中LIF浓度对评价子宫内膜容受性、预测临床妊娠结局具有重要意义。

Relationships of thickness and types of endometria in window of implantation and leukemia inhibitory factor with outcome of in vitro fertilization and embryo transfer

Objective To explore the possible relationships of thickness and types of endometria in the window of implantation and leukemia inhibitory factor（ LIF） in uterine flushing fluid with the outcome of in vitro fertilization and embryo transfer（ IVF-ET）. Methods A total of 105 patients with infertility who underwent in vitro fertilization（ IVF） or intracytoplasmic sperm injection（ ICSI） were examined in the window of implantation（ 7-9days after ovulation） before the previous cycle of IVF-ET. The thickness and sonographic appearance of endometrium was measured by transvaginal ultrasonography,and the concentrations of LIF in uterine flushing fluid by enzyme linked immunosorbent assay（ ELISA）. Results Sixty-four patients were successful in pregnancy and 41 patients failed after treatment. There was no difference in age,infertility time and infertility type between pregnant women and non-pregnant women. The endometrial thickness in the window of implantation of pregnant women was significantly less than that of non-pregnant ones [（ 11. 89 ± 1. 63） mm vs（ 13.72 ±2.39） mm]（ P〈 0.05）. The endometrial thickness was divided into three groups： 7-10mm,10-13mm and 13-17mm,and the corresponding pregnant rates were 40%,72. 73% and 41. 38%. The endometrial type of 50 women was A,of 36 women was B and of 19 women was C,and the corresponding pregnant rates were 70%,63. 9% and 31. 6%. There was significant difference in the pregnant rate between type A and B,between type A and C（ all P〈 0. 05）,but there was no significant difference between type B and C（ P〈 0. 025）. The concentration of LIF in uterine flushing fluid of pregnancy group was higher than non-pregnancy group [（ 41. 19 ± 31. 02） pg /mL vs（ 23. 43 ± 23. 09） pg /mL]（ P〈 0. 05）. Conclusions It is important to examine the thickness and types of endometria by transvaginal ultrasonography and the concentration of LIF in uterine flushing fluid in the previous cycle of IVF-ET for the assessment of endometrial rec