经阴道三维超声测定子宫内膜容积对IVF-ET结局的预测价值  

Role of Endometrial Volume Measured by Transvaginal Three-dimensional Ultrasound in the Prediction of Pregnancy during IVF-ET Treatment

作　　者：王锦惠[1] 门殿霞[1] 于子芳 闫芳[1] 李春敏[1] 肖文丽[1] 刘英[1] 张烁[2] 

机构地区：[1]太原市第二人民医院超声诊断科,太原市030002 [2]太原市中心医院生殖中心

出　　处：《中国超声医学杂志》2010年第12期1112-1115,共4页Chinese Journal of Ultrasound in Medicine

基　　金：太原市科技局科技兴市项目(No.0802055)

摘　　要：目的探讨子宫内膜容积对体外受精胚胎移植(IVF-ET)结局的预测价值。方法应用经阴道三维超声对120例接受IV-ET的不孕症患者于控制性超排卵(COH)周期人绒毛膜促性腺激素(HCG)注射日进行子宫内膜厚度及内膜容积的检测。根据妊娠与否分为两组,比较两组之间内膜厚度、内膜容积有无差异;根据内膜容积将患者分为三组(<2 ml、2～4 ml、>4 ml),比较各组之间妊娠率有无统计学差异。结果 120例患者中临床妊娠39例,妊娠率为32.5%,妊娠组与未妊娠组间子宫内膜厚度、内膜容积无统计学差异;子宫内膜厚度与内膜容积预测妊娠的ROC曲线下面积分别为0.584和0.557;内膜容积<2 ml组、2～4 ml组、>4 ml组临床妊娠率分别为0%、31.9%和35.3%,三组之间临床妊娠率无统计学差异;子宫内膜厚度与内膜容积有相关性.但非线性相关。结论子宫内膜厚度、内膜容积不能预测IVF-ET结局,但对于临床是否进行ET具有指导意义。Objective To investigate the role of endometrial volume in predicting the outcome in an in-vitro fertilization embryo transfer（IVF-ET ）program. Methods One hundred and twenty patients undergoing IVF cycles were enrolled in this study. Transvaginal three-dimensional ultrasound examinations were performed by experienced sonographers on the day of human ehorionic gonadotropin（HCG） injection. Endometrial volume and thickness were measured in each scan. Results of these cycles were recorded. The study group was divided into endometrial volume subgroups of〈2 ml, 2-4 ml, 〉4 ml. Pregnancy rates （PRs） were compared among the subgroups. Mann-Whitney and Chi-square test were used to test for the relationship between PRs and endometrial volume. The receiver operator characteristic （ROC） curve analysis was applied and the area under the curve （AUC）was calculated. Statistic analyses were performed using SPSS 13.0. The two-tailed value of P〈0.05 was considered statistically significant. Results The endometrial thickness and volume between the pregnant group and nonpregnant group showed no significant difference（P〉 0.05）. The endometrial volume subgroups 〈2 ml were with a lower clinical PRs,0% （0/5）. The PRs were 31.9% （15/47） and 35.3 % （24/68） in endometrial volume subgroups of 2 -4 ml and 〉4 ml. There were no significant difference among the three subgroups （P〉0.05）. The relationship between the volume and the thickness was highly significant （rs=0. 725,P〈0.05）. Conclusions Transvaginal 3D ultrasonographic measurement of endometrial volume can help to decide whether ET or not, but it can not be as a reliable indicator to assess endometrial receptivity and to predict the pregnancy outcome.

关 键 词：经阴道三维超声 子宫内膜容积 子宫内膜容受性 受精 体外 胚胎移植 

分 类 号：R445.1[医药卫生—影像医学与核医学] R714.8[医药卫生—诊断学]