彩色多普勒超声评价反复种植失败患者子宫动脉血流特点研究

目的 探讨反复种植失败（recurrent implantation failure，RIF）患者子宫动脉血流及其相关因素的特点。方法 选取2012年3月至2013 年8月于烟台毓璜顶医院生殖医学科因输卵管因素行体外受精-胚胎移植（in vitro fertilization- embryo transfer，IVF－ET）治疗的RIF患者（RIF组，n=40）为研究对象；同期IVF－ET治疗首次助孕成功的患者（首次IVF助孕成功组，n=40），首次IVF－ET助孕治疗失败患者（首次IVF助孕失败组，n=40）为对照组，进行回顾性分析。于注射人绒毛膜促性腺激素（human chorionic gonadotropin，HCG）日行经阴道彩色多普勒超声检查，测量子宫动脉搏动指数（uterine artery pulsatility index，UAPI）、子宫内膜厚度，并同时测定血雌二醇及孕酮值。比较三组间相关指标的差异。结果 RIF组患者UAPI 3.3±0.4，显著高于同期IVF-ET治疗首次助孕成功组2.3±0.5及失败组UAPI 2.4±0.4，差异有统计学意义（P<0.05），而IVF-ET治疗首次助孕成功组与失败组相比，差异无统计学意义（P＞0.05）。3组间的子宫内膜厚度、雌二醇及孕酮值差异无统计学意义（P>0.05）。结论 HCG日测定UAPI有助于评价子宫内膜容受性，预测种植率。

The characteristic of uterine artery pulsatility index in women with recurrent implantation failure evaluated by color Doppler ultrasound.

Abstract： Objective To investigate the value of uterine artery pulsatility index (UAPI) and its correlation factors in patients with recurrent implantation failure (RIF). Methods Between Mar. 2012 and Aug. 2013, forty RIF patients, forty infertility patients who become pregnant after in vitro fertilization- embryo transfer technology and forty infertility patients with implantation faliure after the first time in vitro fertilization- embryo transfer technology were analysed retrospectively. UAPI and endometrial thickness were examined by transvaginal Doppler during the humanchorionic gonadotropin (HCG) injection day, meanwhile estrogen (E2) and progestogen (P) were determined.Results UAPI values were higher in RIF patients than in other two groups（P<0.05）, but no difference was found in endometrium thickness, estradiol and progesterone level（P>0.05）. We observed no correlation between UAPI and endometrial thickness, E2 or P level. Conclusion The measurement of UAPI on HCG day helps to evaluate endometrium receptivity and assess the implantation rate.