超促排卵对不孕女性子宫内膜蠕动波的影响  

Influence of Controlled Ovarian Hyperstimulation on Uterine Peristalsis in Infertile Women

作　　者：朱琳[1] 李艳萍[1] 徐爱装[1] 

机构地区：[1]中南大学湘雅医院妇产科生殖医学中心,长沙410008

出　　处：《生殖与避孕》2013年第2期83-88,共6页Reproduction and Contraception

基　　金：湖南省科学技术厅科技计划一般项目(2012FJ6005)

摘　　要：目的:研究不孕女性自然周期与控制性超促排卵(COH)周期子宫内膜蠕动波的特点。方法:64名排卵正常的不孕女性分别于自然周期LH峰日、排卵日、排卵后2 d和COH周期hCG注射后1 d、采卵日、采卵后2 d阴道超声监测子宫内膜蠕动波,且同时测定血清雌、孕激素水平。结果:自然周期子宫内膜蠕动波频率是COH周期的1.31倍;COH周期与自然周期各个观测日的子宫内膜蠕动波类型分布不同;子宫内膜蠕动波频率与生理水平血清雌二醇(E2)呈正相关,与孕酮(P)呈负相关,与超生理剂量的雌、孕激素无相关性。结论:COH治疗显著地改变了子宫内膜蠕动波的自然运动模式,在胚胎移植前仍表现为较强烈的子宫内膜运动。Objective： To explore the characteristics of uterine peristalsis in natural and controlled ovarian hyperstimulation （COH） cycles. Methods： Sixty-four infertile women with regular and ovulatory menstrual cycles underwent follicular tracking in natural cycle and the subsequent COH cycle after ovarian stimulation （GnRH-agonist down-regulation）. Three time points were studied in both cycles including LH surge day/1 d after hCG injection, ovulation/oocyte retrieval and 2 d after ovulation/retrieval. Results： Uterine peristaltic wave frequency was 1.31 times higher in the COH cycle than in the natural cycle （P〈0.01）. At all three time points in the COH cycle, waves moving from the cervix to fundus dominated, comprising 80%-90% of the wave types were observed, while ＇no activity＇ was more frequently observed in the natural cycle. The wave frequency was positively correlated with the level of serum estradiol （E2） （r =0.30, P〈0.01） and negatively correlated with the progesterone （P） level （r=-0.48, P〈0.01） for the physiological range of steroid levels. No correlation was found between the wave frequency and supraphysiological concentrations of E： or P. Conclusion： COH significantly changed uterine peristaltic pattern. The endometrial movements did not weaken to the natural level before embryo transfer, even with high level of progesterone

关 键 词：控制性超促排卵(COH) 子宫蠕动波 子宫内膜 蠕动波频率 IVF ICSI 

分 类 号：R714.8[医药卫生—妇产科学] R711.6[医药卫生—临床医学]