阴道超声评估子宫内膜容受性的研究

目的:研究超声下子宫内膜形态、厚度与妊娠结局的关系,以期获得能够评估子宫内膜容受性的超声预测指标。方法:阴道超声监测本中心520个供精人工授精助孕治疗周期妇女人绒毛膜促性腺激素(hCG)日及种植窗日(排卵后7d)子宫内膜形态分型和厚度。根据hCG日内膜厚度分为7组,种植窗日内膜厚度分为6组,分析和比较内膜类型及厚度与妊娠结局的关系。结果:子宫内膜A型组临床妊娠率(28.95%)高于C型组(9.09%,P<0.05),B型组与C型组hCG日与种植窗日子宫内膜厚度均大于A型组(P均<0.05);妊娠组与未妊娠组hCG日子宫内膜厚度无差异(P>0.05),妊娠组种植窗日子宫内膜厚度小于未妊娠组(P<0.05)。hCG日子宫内膜厚度10～<12mm组妊娠率最高,<7mm及≥15mm组无妊娠发生;种植窗日子宫内膜厚度9～<13mm组妊娠率最高,<8mm及≥17mm组无妊娠发生。结论:阴道超声监测子宫内膜类型与厚度对评估内膜容受性、预测临床妊娠结局具有重要意义,同时为辅助生殖治疗提供可靠的内膜容受性调整依据。

Study on endometrial receptivity assessment with transvaginal ultrasonorgraphy

Objective：To investigate the relationship between the sonographic appearance of the endometrium,the endometrial thickness and pregnancy outcome.Methods：A total of 520 women who underwent artificial insemination of donor for assisted reproductive treatment cycles in reproductiven center of National Research Institute for Family Planning were recruited.And the endometrial thickness and sonographic appearance of the endometrium were detected on the day of hCG administration and the window of implantation （7 days after ovulation） by transvaginal ultrasound.Women were divided into seven groups and six groups according to the thickness of endometria on the day of hCG administration and the window of implantation,respectively.The outcome of pregnancy was evaluated.Results：The clinical pregnancy rate in group A （28.95%） was significantly higher than that of group C （9.09%,P0.05）.The endometrial thickness on the day of hCG administration and the window of implantation in group B and group C were significantly greater than that of group A （P all 0.05）.There was no significant difference in the endometrial thickness between pregnant women and non-pregnant ones on the day of hCG administration （P0.05）.The endometrial thickness on the window of implantation in pregnant women was significantly less than that of non-pregnant ones （P0.05）.The highest pregnancy rate was found in those with 10mm to less than 12mm of the endometrial thickness on the day of hCG administration,and no pregnancy occurred when the endometrial thickness was less than 7mm or not less than 15mm.In addition,the highest pregnancy rate was found in those with 9mm to less than 13mm of the endometrial thickness on the window of implantation,and no pregnancy occurred when the endometrial thickness was less than 8mm or not less than 17mm.Conclusion：It is important of the endometrial appearance and the endometrial thickness evaluated by transvaginal sonographic in the assessment of endometrial receptivity,which could predict the clinical outcome of pregnancy and provide a reliable basis for adjustment of endometrial receptivity in assisted reproductive treatment.