摘要
目的探讨胚胎移植日超声观察子宫内膜运动波对冻融胚胎移植(FET)周期临床妊娠结局的预测价值。方法选取2009年12月至2010年12月在本中心采用雌孕激素替代方案行FET的144个周期,激素替代方案准备内膜,达到标准者[内膜厚度≥7 mm,形态A或A-,黄体酮转化日雌二醇(E2)≥120 pg/ml]行FET。根据临床妊娠结局分为妊娠组(68例)和非妊娠组(76例)。测定两组妇女黄体酮转化日血清雌激素水平以及移植日血清雌、孕激素水平;阴道超声观察黄体酮转化日内膜形态、厚度和移植日子宫内膜厚度、运动波波形和频率。统计分析各影响因素与妊娠结局的相关性。结果子宫内膜运动波的波形及频率与临床妊娠率相关,宫底至宫颈型(FC)波形及高频率运动波(≥4次/min)与临床妊娠率呈负相关,OR值分别为1.43及0.96;血清激素水平及子宫内膜厚度及形态对于妊娠结局无明显影响。结论子宫内膜运动波的波形与频率变化与临床妊娠率密切相关,提示观测子宫内膜运动波可以辅助综合评判种植窗,对预测妊娠结局有实际意义。
Objective To investigate the endometrial wave on embryo transfer day influencing the prognosis of IVF-ET.Methods Totally 144 freeze-thaw embryo transfer(FET) in HT cycles were analyzed.All the cases were from 25 to 35 years old,endometriosis,adenomyosis,uterine fibroids and endometrial polyps were excluded.Two embryos were transferred,each score 8.Results Implantation rate was 23.6%,pregnant rate was 43.8%.Through logistic regression analysis,we found that the endometrial wave played important role in the clinical results,especially the frequency(OR=0.96,95% CI: 0.91~0.98).It appeared a decrease of pregnance rate with FC endometrial wave pattern and high frequency.Conclusions In our HT protocal of FET,the endometrial thickness,pattern,hormone level had no influence on the pregnant rate,while the endometrial wave pattern and frequency showed close correlation with outcomes.It suggested that examing endometrial wave in HT cycle of FET has practical significance,which can help select the best transfer time and improve the endometrial receptivity to elevate the clicial pregnancy rate.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第14期4033-4037,共5页
Chinese Journal of Clinicians(Electronic Edition)
基金
上海交通大学医学院科技基金(YZ1041)
2010年上海市教委优秀青年教师培养基金
关键词
胚胎移植
激素替代疗法
子宫内膜运动波
容受性
Embryo transfer
Hormone replacement therapy
Endometrial wave
Endometrial receptivity
