摘要
目的 通过二维及三维超声分别测量子宫内膜血流,探讨两种方法在体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)中的应用价值。方法 选取2018年1-12月在联勤保障部队第九八〇医院生殖医学中心首次接受胚胎移植的患者212例(年龄<35岁),按内膜准备方案分为自然周期组(72例)、促排卵周期组(70例)、人工周期组(70例),在人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)注射日(简称HCG日)或内膜转化日进行二维及三维超声测量,二维超声监测子宫内膜厚度、内膜形态、内膜及内膜下血流情况、子宫动脉血流参数,三维超声监测子宫内膜容积、内膜血流参数包括血管指数(vascularization index,VI)、血流指数(flow index,FI)、血管血流指数(vascularization flow index,VFI),对各指标进行分组比较,并进行统计学分析。结果 212例胚胎移植患者,妊娠组109例,未妊娠组103例,妊娠率51.4%。内膜血流Ⅱ型患者组的妊娠率(47.6%)及内膜血流Ⅲ型患者组的妊娠率(66.7%)明显高于内膜血流Ⅰ型患者组的妊娠率(21.4%),差异有统计学意义(P<0.05);妊娠组HCG日或内膜转化日子宫动脉血流PI、RI、S/D值均低于未妊娠组,差异有统计学意义(P<0.05),ROC曲线下面积分别为0.632、0.664、0.647,其截断值分别为2.397、0.845、5.215。妊娠组HCG日或内膜转化日内膜VI、FI、VFI均高于未妊娠组,差异有统计学意义(P<0.05),ROC曲线下面积分别为0.75、0.67、0.73,其截断值分别为1.76、22.53、0.45。结论 二维及三维超声监测内膜血流可为临床医师选择移植时机提供指导。
Objective To measure the blood flow of endometrium by using two-dimensional(2-D)and three-dimensional(3-D)ultrasound and explore the value of the two methods in IVF-ET.Method The 212 patients(age<35 years)were selected for the first embryo transplantation in our hospital from January 2018 to December 2018.According to the inner membrane preparation scheme,patients were divided into natural cycle group,ovulation cycle group and artificial cycle group.2-D and 3-D ultrasound were performed on HCG day or endometrial transformational day.2-D ultrasound monitored endometrial thickness,endometrial morphology,endometrial and subendometrial blood flows,and uterine arterial blood flow parameters.3-D ultrasound measured endometrial volume and endometrial blood flow parameters including vascularization index(VI),blood flow index(FI),and the vascularization flow index(VFI).Those ultrasound parameters were compared and analyzed between three groups.Result Among 212 embryo transplantation patients,109 cases were in pregnancy group and 103 cases in unpregnant group with a pregnancy rate of 51.4%.The pregnancy rate of typeⅡ(47.6%)and typeⅢ(66.7%)were significantly higher than that of patients with typeⅠ(21.4%).The PI,RI and S/D values of uterine artery blood flow on HCG day or endometrial transformation day in pregnancy group were lower than those in non-pregnancy group with significant differences(P<0.05).The area under ROC curve was 0.632,0.664 and 0.647 respectively.The cutoff values were 2.397,0.845 and 5.215 respectively for the prediction of pregnancy.The endometrial VI,FI and VFI of HCG day or endometrial transformation day in the pregnant group were significantly higher than those in the non-pregnant group.The areas under the ROC curve were 0.75,0.67 and 0.73 respectively,and the cutoff values were 1.76,22.53 and 0.45 for the prediction of pregnancy.Conclusion Monitoring of endometrial blood flow by 2-D and 3-D ultrasound can provide guidance for clinicians to choose the timing of embryo transplantation.
作者
刘秀萍
杨红玉
惠冉
包莉莉
程立立
苗蕊
Liu Xiuping;Yang Hongyu;Hui Ran;Bao Lili;Cheng Lili;Miao Rui(Department of Obstetrics and Gynecology,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,Hebei,China;Department of Obstetrics and Gynecology No.980 Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army/Bethune International Peace Hospital of PLA,Shijiazhuang 050082,Hebei,China;Department of Ultrasound Hebei Maternity Hospital,Shijiazhuang 050000,Hebei,China)
出处
《中国医学前沿杂志（电子版）》
2022年第7期45-50,共6页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
2019年度河北省医学科学研究课题计划(20191193)。
