卵巢储备功能下降妇女行促排卵疗法后经阴道彩超结果分析

目的 分析经阴道彩超检查卵巢储备功能下降妇女行促排卵疗法后的变化.方法 选取2013年6月至2016年6月期间我院收治的116例卵巢储备功能下降患者为研究对象,所有患者均经彩色多普勒超声检测卵巢间质动脉血流收缩期最大血流速度/舒张期末期血流速度(S/D)、卵巢最大切面平均直径(MOD)、窦卵泡数(AFC)、卵巢间质冬眠峰值流速(PSV)、卵巢动脉搏动指数(PI)、阻力指数(RI)、血清卵泡雌激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平、子宫体积、子宫内膜厚度和卵巢平均容积和妊娠率.分别于自然月经周期第2~3天测定和经促排卵疗法治疗后测定,并指导患者同房或进行宫腔内人工授精.结果 治疗后卵巢储备功能下降患者的S/D较治疗前差异无统计学意义(P>0.05),治疗后卵巢储备功能下降患者的MOD、AFC、PSV、PI、E2水平、子宫体积、子宫内膜厚度、卵巢平均容积和妊娠率分别为(25.34±2.16)cm、(9.47±1.95)个、(15.13±2.15)cm/s、(2.31±1.15)、(74.82±9.28)pg/mL、(105.18±49.39)cm、(6.35±1.74)mm、(7.59±3.44)cm、27.59%,高于治疗前的(20.75±2.93)cm、(6.14±0.32)个、(9.11±2.86)cm/s、(1.95±0.62)、(32.47±10.78)pg/mL、(100.37±56.86)cm、(5.52±1.75)mm与(5.41±2.34)cm、0,RI、血清FSH和LH水平为(0.54±0.06)、(27.08±13.47)mIU/mL、(21.72±14.44)mIU/mL,较治疗前(0.63±0.08)、(67.32±29.09)mIU/mL、(60.83±18.67)mIU/mL]显著降低,差异具有统计学意义(P<0.05).结论 促排卵疗法能够显著改善卵巢储备功能下降患者的卵巢储备功能,改善子宫状况和血清性激素水平,且经阴道彩超检查能够较好反映出患者治疗后的变化,对卵巢储备功能具有较好评价作用.

Analysis of transvaginal color Doppler ultrasound on diminished ovarian reserve patients undergoing ovulation induction therapy.

Objective To analyze the changes of ovarian reserve in diminished ovarian reserve women after ovulation induction by transvaginal color Doppler ultrasonography. Methods A total of 116 hospitalized women with diminished ovarian reserve from June 2013 to June 2016 were investigated. All patients were diagnosed by color Dop-pler ultrasound detection of ovarian stromal artery blood flow peak systolic velocity and end diastolic velocity (S/D), mean maximum ova diameter (MOD), number of antral follicles (AFC), ovarian stromal hibernation peak systolic ve-locity (PSV), ovarian artery pulsatility index (PI), resistance index (RI), serum follicle stimulating hormone (FSH), lu-teinizing hormone (LH), estradiol (E2) levels, uterine volume, endometrial thickness, mean ovarian volume and preg-nancy rate. The assessments were undertaken between days 2~3 of a menstrual cycle or ovulation induction cycle re-spectively, to provide the patients information on pregnancy of having sexual intercourse or intrauterine insemination. Results There was no significant difference in S/D between before and after treatment for patients with diminished ovarian reserve (P>0.05). After treatment, the patients' MOD, AFC, PSV, PI, E2 level, uterine volume, endometrial thickness, mean ovarian volume and pregnancy rate were (25.34 ± 2.16) cm, (9.47 ± 1.95), (15.13 ± 2.15) cm/s, (2.31 ± 1.15), (74.82 ± 9.28) pg/mL, (105.18 ± 49.39) cm, (6.35 ± 1.74) mm, (7.59 ± 3.44) cm, 27.59%, respectively, higher than those before treatment (20.75 ± 2.93) cm, (6.14 ± 0.32), (9.11 ± 2.86) cm/s, (1.95 ± 0.62), (32.47 ± 10.78) pg/mL, (100.37 ± 56.86) cm, (5.52±1.75) mm, (5.41±2.34) cm and 0. While the RI, serum FSH and LH levels were (0.54±0.06), (27.08± 13.47) mIU/mL, (21.72 ± 14.44) mIU/mL, respectively, significantly lower than (0.63 ± 0.08), (67.32 ± 29.09) mIU/mL, (60.83±18.67) mIU/mL before treatment (P<0.05). Conclusion Ovulation induction therapy can significantly improve the ovarian reserve function in patients with diminished ovarian reserve, improve uterine status and serum sex hormone levels. The change of patients after treatment may be reflected by transvaginal color Doppler ultrasound, through which the ovarian reserve function may also be assessed.