IVF-ET周期中HCG日子宫内膜与临床结局的关系

目的评价IVF-ET周期中HCG日子宫内膜的厚度和回声类型对临床结局的预测价值。方法回顾性分析1686个IVF-ET治疗周期,HCG日经阴道B超测量子宫内膜的厚度和回声类型,按子宫内膜厚度分为5组,分别为:1组≤6mm14例、2组7～8mm158例、3组9～12mm843例、4组13～16mm564例、5组≥17mm112例;按内膜类型分为3组,分别为:A型1267例、B型286例、C型139例,比较各组患者的临床妊娠率、胚胎着床率、早期流产率及异位妊娠率。结果 (1)①五组的临床妊娠率分别为7.1%、39.9%、46.7%、53.2%、51.8%(P<0.05),2、3、4、5组各组之间临床妊娠率差异无统计学意义(P>0.05),1组与其他各组临床妊娠率差异有统计学意义(P<0.05);②胚胎着床率分别为3.2%、22.1%、29.1%、34.2%、32.8%(P<0.05),2、3、4、5组各组之间胚胎着床率差异无统计学意义(P>0.05),1组与其他各组胚胎着床率差异有统计学意义(P<0.05);③早期流产率分别为0、2.6%、3.4%、3.4%、1.8%(P>0.05);④异位妊娠率分别为0、5.2%、2.3%、1.9%、0.9%(P>0.05),7～8mm的异位妊娠率高于≥9mm的异位妊娠率。(2)①A、B、C型三组的临床妊娠率分别为48.8%、45.7%、41.3%(P>0.05);②胚胎着床率分别为30.3%、30.3%、26.7%(P>0.05);③早期流产率分别为3.1%、2.1%、5.1%(P>0.05),C型内膜的流产率高于A型和B型的流产率;④异位妊娠率分别为2.4%、2.1%、0.7%(P>0.05)。结论 IVF-ET临床治疗的结局与HCG注射日子宫内膜厚度和类型直接相关。

Relation of Transvaginal Sonographic Endometrial Appearance On the Day of HCG Injection with Clinical Pregnancy by in vitro Fertilization

Objective In order to assess the predictive value of transvaginal sonographic endometrial thickness and pattern on the day of HCG injection to clinical pregnancy by in vitro fertilization and embryo-transfer(IVF-ET).Methods A retrosp ective study analyzed the pregnancy in 1686 cycles of IVF-ET.Patients were classified in five categories of endometrial thickness:≤6mm(n=14),7-8mm(n=158),9-12mm(n=843),13-16mm(n=564) and ≥17mm(n=112) and in three types of endometrial pattern:type A,type B,type C.The pattern and the thickness of the endometrium were assessed by transvaginal sonography on the day of HCG injection.Comparing clinical pregnancy,implantation,miscarriage rates,ectopic pregnancy rates.Results (1)In the endometrial thickness aspect:①Pregnancy rates were respectively 7.1%、39.9%、46.7%、53.2%、51.8%(P <0.05);②Implantation rates were res Pectively 3.2%、22.1%、29.1%、34.2%、32.8%(P <0.05);③miscarriage rates were respectively 0、2.6%、3.4%、3.4%、1.8%(P >0.05);④ectopic pregnancy rates were respectively 0、5.2%、2.3%、1.9%、0.9%(P >0.05),but in cycles where the endometrial thickness was 7-8mm had significantly higher ectopic pregnancy rates compared with other groups.(2)In the endometrial pattern aspect:①pregnancy rates were respectively 48.8%、45.7%、41.3%(P >0.05);②implantation rates were resPectively 30.3%、30.3%、26.7%(P >0.05);③miscarriage rates were respectively 3.1%、2.1%、5.1%(P >0.05),but the miscarriage rates of type C endometium was about as two times as the miscarriage rates of type A and type B endometium.④ectopic pregnancy rates were respectively 2.4%、2.1%、0.7%(P >0.05).Conclusion There is a direct relation between endometrial thickness and pattern on the day of HCG injection and clinical results.