子宫内膜三维超声能量多普勒血流图预测冻融优良胚胎移植妊娠结局

目的:探讨三维超声能量多普勒血流图(3-DU-PDA)在预测自然周期冻融优良胚胎移植(FET)后不同妊娠结局患者的子宫内膜血流灌注特点的价值.方法:选择南方医院生殖医学中心2008年12月至2009年12月189例自然周期FET患者,按移植后第10 ～ 12天血β-HCG结果分为妊娠组(98例)和非妊娠组(91例);移植后第10周再将妊娠组分为持续妊娠组(87例)和早期流产组(11例).分别比较妊娠组和非妊娠组、持续妊娠组和早期流产组的临床特征和子宫内膜3-DU-PDA参数.结果:①妊娠组和非妊娠组、持续妊娠组和早期流产组的基本临床特征、促排卵药物用量、黄体生成素(LH)峰日血雌二醇(E2)浓度、内膜厚度、内膜形态、移植胚胎数、着床率比较,差异均无统计学意义(P＞0.05).②妊娠组和非妊娠组3-DU-PDA各项参数比较,差异无统计学意义(P＞0.05);持续妊娠组内膜血管指数(Ⅵ)和血管血流指数(VFI)均高于早期流产组,差异有高度统计学意义(P=0.000,P=0.006).③采用ROC曲线分别确定子宫内膜Ⅵ和VFI预测持续妊娠结局的效能,子宫内膜Ⅵ的ROC曲线下面积为0.579 (95％ CI 0.498 ～0.660),内膜VFI的ROC曲线下面积为0.584(95％ CI 0.503 ～0.666).结论:自然周期LH峰日子宫内膜血管化参数不能预测冻融优良胚胎FET的着床结局,但在一定程度上能够预测着床后的早期流产.     

三维超声参数积分评估人工授精妊娠结局的价值研究

目的:探讨三维超声参数量化积分对子宫内膜容受性和妊娠结局的评估预测价值。方法:经阴道三维超声对216例自然周期夫精人工授精(AIH)患者行子宫内膜形态学、血流动力学及容积血流参数等多项指标测量,选择有统计学意义的参数进行量化积分,比较超声参数积分较高组与较低组的妊娠结局。结果:正常妊娠组与未妊娠组的子宫内膜厚度比较,差异无统计学意义(P0.05);两组患者的内膜容积、内膜形态、内膜蠕动波比较,差异均有统计学意义(P0.05)。妊娠组的血流动力学参数[(搏动指数)PI、阻力指数(RI)、收缩峰与舒张末期血流速度比(S/D)]均低于未妊娠组(P0.05)。两组的容积血流参数中血管化指数(VI)、血管化-血流指数(VFI)比较,差异无统计学意义(P0.05);妊娠组的血流指数(FI)高于未妊娠组(P0.05)。超声参数积分较高与较低者的临床妊娠率分别为62.96%(51/81)和21.93%(34/155),差异有统计学意义(P0.05)。结论:经三维超声参数量化积分可用于辅助生殖技术中评测内膜容受性及妊娠结局。     

彩色多普勒超声检测子宫内膜和内膜下血流评价IVF-ET结局

目的:探讨hCG注射日应用彩色多普勒超声检测子宫内膜和内膜下血流预测IVF-ET的结局。方法:应用彩色多普勒超声检测hCG注射日子宫内膜和内膜下血流分布情况,将115例IVF-ET/ICSI-ET助孕患者分为A组(n=56):子宫内膜和内膜下均有血流通过;B组(n=42):内膜下有血流但内膜没有血流通过;C组(n=17):内膜和内膜下均无血流通过。随访IVF-ET结局,按妊娠与否分为妊娠组(n=53)与非妊娠组(n=62)。比较A、B、C组的临床特征、卵巢反应、内膜厚度及类型和妊娠结局;比较妊娠组与非妊娠组内膜厚度和类型。结果:A、B、C组间的临床特征、卵巢反应差异无统计学意义,内膜厚度C组低于A组和B组(P<0.05),但3组内膜形态比较差异无统计学意义;A、B、C组妊娠率(62.5%、33.3%、23.5%)和种植率(37.9%、18.4%、10.8%)比较差异有统计学意义(P<0.05)。妊娠组与非妊娠组的内膜厚度及类型比较差异均无统计学意义。结论:hCG注射日应用彩色多普勒超声检测子宫内膜和内膜下血流对IVF-ET的结局有一定的预测价值,是一种较好的、能在临床上普遍开展的无创伤性的预测方法。     

子宫内膜异位症对体外受精-胚胎移植妊娠结局的影响

目的探讨子宫内膜异位症对体外受精.胚胎移植(IVF-ET)妊娠结局的影响.方法对2003年4月至2005年12月69例子宫内膜异位症合并不孕症及同期73例输卵管性不孕症行IVF-ET的患者进行回顾性分析,子宫内膜异位症按照临床病理类型分为A、B两组,A组为卵巢型,B组为腹膜型,随机选同期输卵管性不孕患者为C组,比较A、B、C 3组间的促性腺激素(Gn)的用量、卵子数、受精率、临床妊娠率、种植率和分娩率.结果子宫内膜异位症A、B两组使用Gn总量显著高于C组(P＜0.05),获卵数显著低于C组(P＜0.05),而受精率、临床妊娠率、种植率、分娩率在3组间差异无显著性.结论子宫内膜异位症降低卵巢对超促排卵的反应性使获卵数减少,但不影响IVF-ET的妊娠结局.     

彩色和能量多普勒超声对高危妊娠胎盘绒毛动脉的血流监测及与妊娠结局的关系

目的　研究高危妊娠胎盘循环的病理生理变化及与其妊娠结局的关系。方法　将研究对象根据脐血流S/D值和临床症状将 1 0 2例研究对象分为三组 :脐血流S/D≥ 95 th%者 37例为胎儿 -胎盘供血不足组 ;脐血流S/D <95 th%者同时有妊娠合并症及并发症者 4 2例为妊娠合并症和并发症组 ;无任何妊娠合并症和并发症2 3例作为正常妊娠对照组。经彩色和能量多普勒超声检测三组脐动脉、胎盘内绒毛动脉的阻力及计数胎盘内绒毛血管的条数并与妊娠结局相比较。结果　脐血流S/D≥ 95 th%的孕妇胎盘内绒毛血管的数量明显低于正常妊娠组和妊娠合并症、并发症组 ,胎盘内绒毛动脉的S/D值均显著高于其他两组。虽然正常组和妊娠合并症及并发症组脐动脉血流S/D值均小于 95 th% ,但妊娠合并症和并发症组胎盘内绒毛血管的数量显著低于正常组 ,胎盘内绒毛动脉S/D值显著高于正常组。三组中胎儿 -胎盘供血不足组妊娠结局最差 ;妊娠合并症和并发症组胎儿体重和胎盘重量居中 ;正常妊娠无不良围产儿结局。结论　彩色和能量多普勒超声可监测胎盘内绒毛血管数量及绒毛动脉的阻力 ,其血流动力学的变化为进一步洞察高危妊娠胎盘循环提供了直接依据     

定量三维彩色能量多普勒超声评估剖宫产后子宫瘢痕部位妊娠的价值

目的:应用三维彩色能量多普勒超声(3D-CPA)定量检测剖宫产后子宫瘢痕部位妊娠(CSP)种植处微循环血管参数并评价其对该疾病诊疗的价值。方法:选择甲氨蝶呤子宫动脉栓塞化疗(简称栓塞化疗)后行人工流产的胚囊型CSP的患者38例,使用经阴道彩色多普勒超声和3D-CPA对患者进行检查并测量病变部位栓塞化疗术前及术后1周相应的血管参数,包括:血管形成指数(VI)、血流指数(FI)、血管形成-血流指数(VFI)、搏动指数(PI)、阻力指数(RI)。分析栓塞化疗术前VI、FI、VFI与患者血β-HCG值及PI、RI的关系。按刮宫时出血量≤100ml与>100ml分组并比较栓塞化疗术前检查时血管参数。结果:①栓塞化疗术前的VI值与血β-HCG值呈正相关(r=0.952,P<0.01),术前VI、FI、VFI与RI呈负相关(r=-0.456,r=-0.324,r=-0.298;P<0.05);②栓塞化疗术后的VI值(6.564±2.089)明显低于栓塞化疗前(11.223±2.865)(P<0.01);③刮宫术中出血量>100ml的患者栓塞化疗前的VI值(14.506±2.897)明显大于出血量≤100ml的患者VI值(8.989±2.324)(P<0.01)。结论:运用3D-CPA定量检测CSP微循环参数,其中VI值为较有价值的指标,结合其他辅助检查可为该疾病的临床诊疗提供有价值的信息。     

控制性超促排卵刺激中子宫内膜息肉对体外受精-胚胎移植妊娠结局的影响

目的:探讨在控制性超促排卵(controlled ovarian hyperstimulation,COH)刺激过程中新诊断的子宫内膜息肉(endometrial polyp,EP)对体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)新鲜周期妊娠结局的影响。方法:选择行IVF/ICSI-ET新鲜周期的3 003例患者的3 003个周期进行回顾性分析。IVF/ICSI-ET术前行相关检查诊断宫腔形态正常,根据在COH过程中是否新发现EP将其分为研究组(新发现息肉,n=60)和对照组(未发现息肉,n=2 943)。观察患者妊娠结局。结果:患者的临床妊娠率、自然流产率、继续妊娠率组间比较,差异均无统计学意义(P0.05)。研究组和对照组生化妊娠率(20.0%vs 9.8%)、异位妊娠率(3.3%vs 0.1%),差异有统计学意义(P=0.035,P0.000 1)。结论:在COH刺激过程中新诊断的与生化妊娠和异位妊娠的发生相关,但不影响IVF-ET新鲜周期的最终临床妊娠率、继续妊娠率以及早期流产率的发生。     

多囊卵巢综合征患者体外受精-胚胎移植后的妊娠结局

目的 分析多囊卵巢综合征(PCOS)患者体外受精-胚胎移植(IVF-ET)后的妊娠结局,及不同表型PCOS患者妊娠结局的差异.方法 选取2005年1月至2010年2月在山东大学附属省立医院生殖医学中心行IVF-ET治疗的PCOS患者631例(PCOS组),按照年龄与孕前体质指数( BMI)配对选择输卵管性不孕患者1423例作为对照组.对两组患者的临床资料进行回顾性分析,比较两组患者IVF-ET治疗后的流产率和单胎妊娠结局.结果 PCOS组和对照组患者IVF-ET后流产率分别为22.7％(143/631)和18.69％(266/1423),两组比较,差异有统计学意义(P＜0.05).PCOS组和对照组孕单胎例数分别为339例和794例,两组单胎妊娠结局为:PCOS组和对照组早产率分别为11.2％(38/339)和6.4％( 51/794),两组比较,差异有统计学意义(P＜0.05);妊娠期糖尿病发生率分别为1.5％(5/339)和0.6％ (5/794)、妊娠期高血压疾病发生率分别为4.7％( 16/339)和3.0％( 24/794)、妊娠天数分别为(272±13)d和(273±10)d、新生儿畸形率分别为0.6％(2/339)和0.8％ (6/794)、足月新生儿出生体质量均为(3.5±0.5) kg,以上各项两组比较,差异均无统计学意义(P＞0.05).PCOS组中规律排卵患者流产率及单胎早产率分别为18.6％(19/102)和8.2％(4/49),与对照组分别比较,差异均无统计学意义(P均＞0.05);稀发排卵患者流产率及单胎早产率分别为23.4％( 124/529)和11.7％ (34/290),与对照组比较,差异有统计学意义(P＜0.05).结论 PCOS患者行IVF-ET治疗后流产率、早产率增加,但PCOS患者中规律排卵型患者各种并发症发生率未升高.     

子宫内膜厚度对体外受精-胚胎移植治疗结局的影响

目的:探讨超促排卵(COH)周期中注射hCG当日的子宫内膜厚度对体外受精-胚胎移植治疗结局的影响。方法:回顾性分析502个IVF/ICSI周期,根据注射hCG当日子宫内膜厚度分为5组,A组:内膜厚度≤9mm,38个周期;B组:内膜厚度10-11mm,111个周期;C组:内膜厚度12-13mm,169个周期;D组:内膜厚度14-15mm,118个周期;E组,内膜厚度≥16mm,66个周期。结果:C组和D组的临床妊娠率(65.68%,67.80%)和种植率(42.59%,43.76%)显著高于A组(65.68%,33.23%)、B组(50.45%,34.31%)和E组(53.03%,31.89%)。结论:注射hCG当日子宫内膜的厚度影响了IVF-ET的治疗结局,厚度处于12-15mm时,更适宜着床。     

子宫内膜异位症影响体外受精-胚胎移植结局的初步探讨

目的　探讨子宫内膜异位症的严重程度对体外受精 胚胎移植 (IVF ET)各个环节的影响。方法　对1999年 1月至 2 0 0 2年 4月在中山大学附属第一医院 10 7例已明确分期的子宫内膜异位症不育患者共 139周期IVF ET与同期输卵管因素不育患者 139例进行的 139周期IVF ET的控制性超排卵 (COH)治疗、受精率、卵裂率、每周期胚胎植入率和临床妊娠率、流产率等进行回顾性对照分析。结果　中、重度子宫内膜异位症不育患者与对照组相比进行IVF治疗时使用促性腺激素的总量增加而获卵数减少。重度患者雌二醇 (E2 )峰值下降 ,流产率增加 ,差异有统计学意义 (P <0 0 5 )。子宫内膜异位症不育患者IVF ET治疗时随着病情加重 ,卵巢对控制性超排卵的反应性下降 ,重度患者流产率增高。结论　子宫内膜异位症影响了卵子与胚胎的发育。     

Effect of pituitary down-regulation on the ovary before in vitro fertilization as measured using three-dimensional power Doppler ultrasound

OBJECTIVE: To evaluate the changes taking place in the ovaries during pituitary down-regulation. DESIGN: Prospective observational study of women undergoing IVF treatment. SETTING: A tertiary referral center for assisted reproduction. PATIENT(S): Forty women who received the long buserelin acetate treatment protocol.Transvaginal three-dimensional power Doppler ultrasound examinations before and after pituitary down-regulation. INTERVENTION(S): Ovarian volume, number of follicles, vascularization index (VI), flow index (FI), vascularization flow index (VFI), and mean gray value (MG). RESULT(S): Before the pituitary down-regulation, the dominant ovary was larger in volume and had a lower MG than the nondominant ovary. After the down-regulation, there was a significant decrease in the volume and number of follicles and an increase in MG. After pituitary down-regulation, the dominant and nondominant ovaries did not differ from each other in any of the parameters. Polycystic ovaries were larger than normal ones before and after the down-regulation, without any differences in MG, VI, FI, or VFI. Right and left ovaries did not differ from each other after the down-regulation. CONCLUSION(S): The differences observed between dominant and nondominant ovaries seem to disappear after pituitary down-regulation. In addition, polycystic ovaries were always larger than the normal ones, but no differences could be detected in the stromal brightness or vascularity either before or after the administration of GnRH agonist therapy.     

Assessment of ovarian vascularization in the polycystic ovary by three-dimensional power Doppler ultrasonography

Objective. To assess whether there are differences in ovarian echogenicity and vascularization as assessed by three-dimensional power Doppler angiography (3D-PDA) between women with polycystic ovaries (PCO) and women with normal ovaries (NO).

Methods. Eighty-three women were classified into two groups according to the 2003 Rotterdam consensus criteria. The NO group comprised women (n = 45) with regular menstrual cycles and proven fertility, whereas the PCO group comprised women (n = 38) with oligo-anovulation, clinical and/or biochemical features of hyperandrogenism, and polycystic ovary morphology at two-dimensional ultrasound. All women were evaluated by means of 3D-PDA. The parameters studied in both groups were follicle number per ovary (FNPO), ovarian volume (OV), mean gray value (MG) and three vascular indices: vascularization index (VI), flow index (FI) and vascularization flow index (VFI).

Results. The PCO group showed a higher mean OV as well as FNPO. No differences in MG, VI, FI and VFI were found between the groups.

Conclusions. 3D-PDA indices are not useful for discriminating between normal and polycystic ovaries.     

促性腺激素使用天数对体外授精-胚胎移植及妊娠结局的影响

目的:比较促性腺激素(gonadotropin,Gn)使用天数对体外授精-胚胎移植/卵细胞浆内单精子显微注射-胚胎移植妊娠结果的影响。方法:回顾分析2009年1月～3月我中心试管婴儿助孕治疗143例,其中IVF周期88例,ICSI周期55例。按使用Gn的天数分为两组:A组使用Gn8～13天,B组使用Gn14～19天(最长19天)。结果:两组一般情况无统计学差异;两组HCG日≥19mm卵泡、≥18mm卵泡、次日血HCG值、内膜厚度类型、胚胎质量、生化妊娠和临床妊娠均无统计学差异;而≥20mm、≥16mm、≥14mm、≥11mm卵泡数以及获卵数A组显著高于B组。结论:Gn使用天数影响获卵数,而内膜厚度类型、胚胎质量、生化妊娠以及临床妊娠率无统计学差异。     

Alteration of vascularization in preeclamptic placentas measured by three-dimensional power Doppler ultrasound

Abstract

Objective: To evaluate the alteration of vascularization in preeclamptic placentas measured by three-dimensional (3D) power Doppler ultrasound.

Methods: We performed a prospective study of placental vascularization and placental volume in 27 singleton pregnancies complicated by preeclampsia and 41 normal pregnancies from 27 to 39 weeks of gestation. The placental volume was analyzed using the VOCAL imaging analysis program and 3D power histogram was used to calculate the placental vascular indices including vascularization index (VI), flow index (FI) and vascularization flow index (VFI).

Results: Of the 27 preeclamptic pregnancies, 9 were complicated by intrauterine growth restriction and 15 were severe preeclampsia. Furthermore, nine of the preeclamptic pregnancies had abnormal end diastolic flow in the umbilical artery. No significant correlation was noted between the placental vascular indices and gestational age in normal pregnancies. The placental vascular indices including VI, FI and VFI were significantly lower in preeclamptic placentas compared with controls (VI, p?<?0.001; FI, p?=?0.022; VFI, p?<?0.001). Preeclamptic placental volume was also decreased compared with that of the controls (p?=?0.002). After adjustment for confounding factors, significant differences were observed in VI and placental volume. However, no correlation was found between 3D power Doppler vascular indices and umbilical artery flow velocities, and neither intrauterine growth restriction nor the severity of preeclampsia could be predicted by the vascular indices.

Conclusion: VI and placental volume are reduced in preeclamptic placenta. Placental vascular indices using 3D power Doppler ultrasound provide insights of placental vascularization in preeclampsia.     

种植窗期预测体外受精-胚胎移植结局指标的研究

目的 探讨种植窗期子宫内膜雌、孕激素受体（ER、PR）及血管内皮生长因子（VEGF）的表达与体外受精-胚胎移植（IVF—ET）结局的关系，选择能预测IVF—ET结局的良好而可靠的指标。方法 2004-05—2005-01对郑州大学第二附属医院生殖中心40例拟行IVF—ET妇女，在IVF—ET前1周期采用免疫组化SP法和组织学积分H—score方法对ER、PR和VEGF在种植窗期子宫内膜中的表达进行定位和半定量分析。按IVF—ET后是否妊娠将40例不孕患者分为两组：妊娠组和未妊娠组。结果 未妊娠组腔上皮、腺体PR表达较妊娠组强，差异有统计学意义（P〈0．05），间质PR表达较妊娠组弱，差异有统计学意义（P〈0．05）；妊娠组和未妊娠组子宫内膜ER表达差异无统计学意义（P〉0、05）；VEGF在子宫内膜中的表达妊娠组较未妊娠组高，差异有统计学意义（P〈0．05）。结论 种植窗期子宫内膜腔上皮、腺体PR下调失败，间质PR表达减弱及子宫内膜VEGF的表达减弱可导致IVF—ET妊娠失败。种植窗期子宫内膜PR和VEGF的表达可作为预测妊娠是否成功的指标。     

子宫内膜切除术后妊娠结局的探讨

目的 探讨经宫颈子宫内膜切除术（TCRE）后妊娠的结局及其处理方法。方法 回顾分析我院TCRE后妊娠26例32例次的妊娠情况及其结局。结果 1例次自然流产,27例次人工流产,其中1例次宫腔粘连,狭窄,用宫腔电切镜切开后吸宫,1例次吸出完整胎囊后出血700ml,一般处理无效,行宫腔球囊压迫止血,另1例次右宫角妊娠,吸宫失败,行经腹子宫切除术,1例次宫颈妊娠,大出血;2例输卵管妊娠,1例足月妊娠,胎盘植入,剖宫产分娩一足月小样儿,同时切除子宫。结论 TCRE后仍有妊娠可能,但其困难流产,胎盘植入,胎儿生长受限,第三产程异常等并发症发生率升高,故应视为高危人群,加强监护。     

The effect of retained embryos on pregnancy outcome in an in vitro fertilization and embryo transfer program

OBJECTIVE: The purpose of this study was to determine the incidence of retained embryos and its impact on pregnancy outcome in the absence of known risk factors like blood and mucus in the transfer catheter. The factors that could be associated with embryo retention were also investigated. STUDY DESIGN: The results of all embryo transfer procedures performed at Ankara IVF Center between January 2003 and December 2005 were analyzed retrospectively. Three hundred and five embryo transfers, in which the transfer catheter was contaminated with blood or mucus, were excluded and the remaining 1,454 embryo transfers, with clean catheter, were enrolled into the study. Both fresh (n=1,422) and frozen (n=32) embryo transfers were included. RESULTS: The overall incidence of retained embryos during study period was 2.8% (41/1,454) following a clean initial embryo transfer. The mean age of the female partner, mean number of retrieved oocytes, MII oocytes, fertilized oocytes and the embryos transferred were similar in patients with and without retained embryos. The 1,454 embryo transfers performed during the study period resulted in 712 pregnancies (49%), of which 639 proved to be clinical pregnancies with a rate of 44%. The implantation rate was 22.8%. Pregnancy outcomes including positive beta-hCG (58.5% versus 48.7%), biochemical (4.7% versus 5.1%) and clinical pregnancy rates (53.6% versus 43.6%), implantation rate (24% versus 22.7%) and multiple pregnancy rate (36.3% versus 44.7%) were not significantly different between patients with and without retained embryos. An influence of individual physicians and embryologists on the frequency of retained embryos was not detected. The type of embryo transfer catheter used did not show any difference in terms of embryo retention. The cleavage stages of embryos were not different between groups. Although it was not statistically significant, the number of embryos transferred appeared to be a potentially confounding factor for retained embryos (p=0.053) and it might be significant in a slightly larger sample. When transfer of one or two embryos was compared to three or more embryos, the likelihood of retained embryos increased from 1.2% (4/321) to 3.2% (37/1,133). CONCLUSION: Retained embryos in the transfer catheter and immediate retransfer of them have no adverse impact on clinical pregnancy and implantation rates unless other previously reported signs of difficult transfer are also observed.     

The role of endometrial blood flow measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during in vitro fertilization treatment

Ultrasound examination of the endometrium is a commonly used non-invasive method to assess endometrial receptivity during in vitro fertilization (IVF) treatment. A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation and therefore assessment of endometrial blood flow in IVF treatment has attracted a lot of attention in recent years. Doppler study of uterine arteries does not reflect the actual blood flow to the endometrium. Endometrial and subendometrial blood flows can be more objectively and reliably measured with three-dimensional power Doppler ultrasound. However, conflicting results are reported with regard to their role in the prediction of pregnancy in IVF treatment. Relevant studies in the literature differed in patients' characteristics, the day of ultrasound examination and the selection of the subendometrial region. As the degree of change in endometrial perfusion from the late follicular phase to the early luteal phase may be a more important determinant of endometrial receptivity, further studies should be conducted to determine the change in endometrial and subendometrial blood flows from late follicular phase to early luteal phase in order to delineate the role of endometrial and subendometrial blood flows in predicting IVF outcome.     

Characterization of normal and polycystic ovaries using three-dimensional power Doppler ultrasonography

Purpose : To evaluate the characteristics of polycystic compared to normal ovaries using three-dimensional (3-D) power Doppler ultrasonography. Methods : We recruited 42 volunteers, all of whom were commencing IVF treatment. Each patient was examined in the cycle preceeding the start of drug therapy during the late follicular phase. If eight or more subcapsular follicles of 2–8 mm in diameter in one two-dimensional (2-D) plane were detected in either of the ovaries, the patient was categorized as having polycystic ovaries (PCO); otherwise the ovaries were considered normal. The parameters examined were volume of the ovary, vascularization index (VI), flow index (FI), vascularization flow index (VFI), and mean greyness (MG). In addition, the ovary was arbitrarily divided into cortex and stroma, and thereafter volume, VI, FI, VFI, and MG were calculated for these two regions. Results : Twenty-eight women had normal ovaries and 14 had PCO. The comparison between normal and PCO showed that as a group the PCO were larger, without any differences in VI, FI, VFI, or MG. In patients with PCO, the right ovary was larger than the left one. In patients with normal ovaries, FI was higher on the left side. Division into cortex and stroma revealed that there were no differences in cortical or stromal VI, FI, VFI, or MG between normal and PCO on either side. Conclusions : The ovaries defined as polycystic were larger than normal ovaries, but there was no difference in the echogenicity of the stroma between polycystic and normal ovaries. We were also unable to demonstrate that the polycystic ovarian stroma was more vascularized than the stroma in the normal ovaries.     

体外受精胚胎移植后妊娠结局分析

目的　探讨通过体外受精 -胚胎移植妊娠妇女的妊娠结局。方法　对自 2 0 0 0年 9月～ 2 0 0 2年1 1月在我院实施IVF -ET的 75例患者 ,80个妊娠周期的临床资料进行回顾性分析。结果　 80个周期中 ,宫内妊娠率 96 2 5 % (77/ 80 ) ,其中自然流产率 2 3 75 % (1 9/ 80 ) ;妊娠 <1 6周流产率 1 6 2 5 % (1 3/ 80 ) ;妊娠 >1 6周流产率 7 5 0 % (6 / 80 ) ,其中 5周期均发生双胎妊娠 ;分娩率 72 5 0 % (5 8/ 80 ) ,早产率 1 5 0 0 % (1 2 / 80 ) ,宫外孕发生率 3 75 % (3/ 80 )。新生儿死亡率 3 6 1 % (3/ 83) ,均死于三胎妊娠早产。结论　减少IVF -ET后多胎妊娠率 ,加强多胎妊娠的整个孕期监护 ,以利于减少多胎妊娠 >1 6周流产率及早产率 ,是降低IVF -ET后妊娠胎儿丢失的有效方法