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。

Assessment of IVF-ET Outcomes by Endometrial and Subendometrial Blood Flows Measured by Vaginal Color Doppler Ultrasound on the Day of hCG Injection

Objective:To discuss the role of endometrial and subendometrial blood flows measured by vaginal color Doppler ultrasound in the prediction of IVF-ET outcomes on the day of hCG injection.Methods:A total of 54 infertile patients undergoing the IVF/ICST-ET cycle were recruited in this study.The patients were divided into three groups according to a color Doppler ultrasound examination performed on the day of hCG injection.Group A(n=56),both endometrial and subendometrial blood flow could be detected;group B(n=42),only subendometrial blood flow could be detected;group C(n=17),the blood flow could not be detected.Otherwise,all the patients were divided into two groups according to their outcomes of IVF-ET:pregnancy group(n=53:intrauterine pregnancy with live fetus after 4-5 weeks for ET) and non-pregnancy group(n=62).Demographic data,ovarian responses,endometrial thickness and echo pattern,outcomes of pregnancy were compared.Results:Demographic data,ovarian responses,endometrial echo pattern had no significant difference among the three groups,but endometrial thick-ness was less in group C than in group A and group B(P<0.05).There was significant difference of the rate of pregnancy and implantation among the three groups.There was no significant difference of endometrial thickness and echo pattern between the pregnancy and non-pregnancy groups.Conclusion:Endometrial and subendometrial blood flows is a good predicator of endometrial receptivity and IVF-ET outcomes on the day of hCG injection,so detecting it viginal color Doppler vltrasound on the loay of hCG injcetion is a good non-invasive method.