实时盆腔超声监测排卵用于人工授精

我们对18例因丈夫患无精症而要求作人工授精的妇女用B超监测排卵而适时作人工授精,共40个周期,计192次B超检查,74次供者人工授精。妊娠率为55.6%。此法较观察基础体温的转变及宫颈评分监测排卵更为准确。妊娠周期中,排卵前优势卵泡的平均直径为20～26mm。迫近排卵的超声显象有:(1)优势卵泡内壁见到一金字塔形的回声区(4/10);(2)优势卵泡周围有一低回声晕(6/10);(3)优势卵泡内壁边缘呈锯齿状(5/10);(4)宫腔线周围有一低回声区(4/5),和/或宫腔内有咖啡豆样显象(2/5)。排卵后的超声显象有:(1)卵泡消失(5/10);(2)卵泡塌陷(4/10);(3)血体形成(1/10);(4)宫腔内有环形显象(3/5)。

REAL TIME PELVIC SONOGRAPHIC MONITORING OF OVULATION FOR ARTIFICIAL INSEMINATION

A B-mode sonographic monitoring of ovulation was performed in 18 women with normal menstrual cycle and possible for artificial insemination. There were 192 B-mode examinations and 74 artificial insemination totally. The pregnancy rate is 55.6%. This method is more accurate than observing BBT shift or cervical scoring for monitoring ovulation. The mean diameter of preovulatory dominant follicles in pregnant cycles are 20～26mm. The images implying the coming ovulation are (1) a pyramid reflectory area at the inner surface of the dominant follicular wall (4/10); (2) a line of decreased reflectivity around the dominant follicle (6/10); (3) a crenation pattern in the inner surface of the follicular wall (5/10); (4) a hyporeflective area around the echogenic uterine line (4/5) and/ or a coffee bean shaped image in the uterine cavity (2/5). The images after ovulation consist of (1) disappearance of the dominant follicle (5/10); (2) collapse of the follicle (4/10); (3) corpus hemorrhagicum formation (1/10); (4)a ring-shaped image in the uterine cavity (3/5).