体外受精-胚胎移植术移植日子宫内膜容受性的超声学研究

目的:探讨体外受精-胚胎移植(IVF-ET)/卵泡浆内单精子显微注射(ICSI)周期胚胎移植日胚胎种植率的影响因素。方法:将实施IVF/ICSI的112个周期根据助孕结局分为妊娠组和非妊娠组,比较两组的E2、P、E2/P及子宫内膜厚度/形态、宫腔深度,并与自然周期模拟移植日子宫内膜厚度/形态、宫腔深度进行自身对照研究。结果:两组超排卵周期胚胎移植日宫腔深度、内膜厚度均显著高于自然周期模拟移植日(P0.001);两组胚胎移植日C型内膜的比率均高于模拟移植日(P0.05),而妊娠组与非妊娠组之间宫腔深度、内膜厚度、C型内膜比率无统计学意义;妊娠组E2、E2/P显著低于非妊娠组(P0.05)。结论:超排卵治疗改变了子宫容积和内膜形态,通过生殖激素的变化而影响IVF/ICSI的妊娠结局。

A sonographic study on endometrial receptivity on implantation day in in vitro fertilization-embryo transfer

Objective:To explore the effect factors of embryo implantation rate on implantation day in in vitro fertilization-embryo transfer (IVF-ET)/intracytoplasmic sperm injection (ICSI).Methods:112 IVF/ICSI cycles were divided into pregnancy group and non-pregnancy group according to pregnancy outcomes.The levels of estradiol,progestin,the ratio of estradiol/progestin,the thickness and morphology of endometrium,the depth of uterine cavity in the two groups were compared,and before-after study was conducted with natural cycles on mimetic implantation day in the thickness and morphology of endometrium,the depth of uterine cavity.Results:The depth of uterine cavity and thickness of endometrium on implantation day in pregnancy group and non-pregnancy group were significantly higher than those in natural cycle on mimetic implantation day (P<0.001); the ratios of pattern C endometrium on implantation day in pregnancy group and non-pregnancy group were significantly higher than that in natural cycle on mimetic implantation day (P<0.05); but there was no significant difference in the depth of uterine cavity,thickness of endometrium and ratio of pattern C endometrium between pregnancy group and non-pregnancy group; the level of estradiol and ratio of estradiol/progestin in pregnancy group were significantly lower than those in non-pregnancy group (P<0.05).Conclusion:Controlled ovarian hyperstimulation may change uterine volume and endometrial morphology,and affect pregnancy outcomes of IVF/ICSI by regulation of reproductive hormones.