促排卵过程中子宫内膜厚度变化对IVF-ET结局的影响

目的:探讨促排卵过程中子宫内膜厚度变化趋势对IVF结局的影响,以及不同促排卵方案对子宫内膜厚度变化趋势的影响。方法:回顾性分析1 173个IVF-ET周期,控制性促排卵方案包括:长方案(568例)、口服避孕药(OC)+GnRHa方案(425例)、拮抗剂方案(107例)和超长方案(73例)。比较各种促排卵方案的妊娠组与非妊娠组的子宫内膜厚度变化情况,包括Gn启动当日、启动后第5日、hCG注射日及子宫内膜差值1(=启动后第5日内膜厚度-启动当日内膜厚度)、子宫内膜差值2(=hCG注射日内膜厚度-启动后第5日内膜厚度)、子宫内膜差值3(=hCG注射日内膜厚度-启动当日内膜厚度)。结果:hCG注射日子宫内膜厚度妊娠组均较未妊娠组显著增加(P<0.05);Gn启动当日子宫内膜厚度、促排卵第5日子宫内膜厚度、子宫内膜厚度差值1、差值2、差值3妊娠组与未妊娠组间均无统计学差异(P>0.05)。结论:促排卵过程中子宫内膜厚度的变化趋势不能预测IVF结果,不同的促排卵方案不影响子宫内膜厚度的变化趋势。

Effect of Changes in Endometrial Thickness in Controlled Ovarian Stimulation on the Outcome of IVF-ET

Objective: To study the effect of changes in endometrial thickness in controlled ovarian hyperstimulation (COH) on the outcome of IVF-ET, and the effect of different controlled ovarian stimulation protocols on the changes in endometrial thickness. Methods: A retrospective analysis was performed on a total of 1 173 IVF-ET cycles. Four COH protocols were used, including long protocol (n=568), OC+GnRHa protocol(n=425), GnRHant protocol (n=107) and super long protocol (n=73). The changes in endometrial thickness were compared between the pregnancy group and the non-pregnancy group of each COH protocol. The changes in endometrial thickness were including: 1) the day of Gn beginning; 2) the 5th day of Gn used; 3) the day of hCG administration; 4) difference 1 of endometrial thickness (=endometrial thickness on the 5th day of Gn used- endometrial thickness on the day of Gn beginning); 5) difference 2 of endometrial thickness (=endometrial thickness on the day of hCG administration - endometrial thickness on the 5th day of Gn used); 6) difference 3 of endometrial thickness (=endometrial thickness on the day of hCG administration - endometrial thickness on the day of Gn beginning). Results: Endometrial thickness on the day of hCG administration of pregnancy group was greater than that of non-pregnancy group of each COH protocol (P<0.05). No significant differences were seen in other measures in endometrial thickness between the pregnancy group and the non-pregnancy group of each COH protocol.Conclusion: Changes in endometrial thickness in COH do not affect the outcome of IVF-ET. COH protocols do not affect changes in endometrial thickness.