经阴道超声评价不孕症患者子宫内膜容受性的临床应用价值

目的进一步探讨经阴道超声评价子宫内膜容受性的临床应用价值。方法应用经阴道彩色多普勒超声（包括二维灰阶超声及彩色能量多普勒超声）进行彩色多普勒血流显像（color Doppler flow imaging,CDFI）检查。观测接受促排卵治疗不孕症患者不同月经周期子宫动脉的阻力指数（resistant index,RI）、搏动指数（pulsatility,PI）值变化以及注射人绒毛膜促性腺激素（human chorionic gonadotrophin,HCG）日子宫内膜厚度、内膜及内膜下血流分布与妊娠的关系,依次测量和记录以下数据：子宫及卵巢的形态、大小、内膜形态、厚度、双侧子宫动脉RI、PI值,然后,采用能量多普勒血流〉显像（power Doppler ultrasonography PDI）,观察内膜及内膜下血流分布状况。结果 60例患者共观察126个月经周期,有28个周期受孕,其中生化妊娠8个周期,临床妊娠20个周期,周期临床妊娠率为15.63%。妊娠组与非妊娠组在女方年龄、不孕年限、子宫内膜厚度方面比较无统计学意义（P〉0.05）,两组之间子宫动脉血流参数、内膜及内膜下血流PDI分型差异有统计学意义（P〈0.05）。结论通过经阴道超声测量子宫动脉的血流频谱,观察子宫内膜的厚度、内膜及内膜下血流分布,并进行综合分析,有助于了解内膜状况,判断其功能状态,评估子宫内膜容受性,对临床治疗有一定的指导意义,从而有助于提高不孕症治疗的成功率。

Clinical value of transvaginal ultrasound for evaluating endometrial receptivity in infertility patients

Objective To study clinical value of transvaginal ultrasound for evaluating endometrial receptivity in infertility patients.Methods All patients were taken color Doppler flow imaging（CDFI）by transvaginal ultrasound.The data of uterus and ovarial morphous,size,endometrial thickness,the resistant index（RI）and pulsatility（PI）of uterine artery were measured and recorded.Blood flow distribution patterns in endometrium was observed by CDFI.Results The results showed 26 menstrual cycles including 8 biochemistry pregnancy circles and 20 clinical pregnancy cycles in 60 cases.The clinical pregnancy rate was 15.63%.The differences of average ages,infertility time and endometrial thickness were no significant（P0.05）between pregnancy group and non-pregnancy group.The difference of blood flow index and PDI typing of blood flow in endometrium and subendometrium was significant（P0.05）.Conclusion The data of endometrial thickness and the blood flow distribution patterns in endometrium and subendometrium by transvaginal ultrasonography may help to evaluate endometrial receptivity and raise pregnaney rate in infertilities that it is guidance meanings.