子宫内膜厚度和形态对体外受精/单精子注射-胚胎移植结果的预测  

The effect of endometrial thickness and pattern on clinical outcome in patients undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer(IVF/ICSI-ET)

作　　者：孔娜[1] 刘景瑜[1] 陈华[1] 王玢[1] 朱静静[1] 孙海翔[1] 

机构地区：[1]南京市鼓楼医院生殖中心,江苏南京210008

出　　处：《临床和实验医学杂志》2013年第9期696-698,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的评估联合注射绒毛膜性腺激素(HCG)日子宫内膜厚度和形态对体外受精/单精子注射-胚胎移植(IVF/ICSI-ET)结果的预测价值。方法分析2011年1月至2011年12月南京市鼓楼医院生殖中心常规长方案行IVF/ICSI助孕新鲜周期移植共520个周期,根据注射HCG日子宫内膜厚度分为组1:子宫内膜厚度≤8 mm(n=14);组2:子宫内膜厚度9～11 mm(n=193);组3:子宫内膜厚度12～14 mm(n=247);组4:子宫内膜厚度≥15 mm(n=65);再根据子宫内膜形态类型分为A型(n=287);B型(n=233);并按照内膜类型分为两个亚组分别比较其临床妊娠率和胚胎种植率。结果共纳入520个IVF/ICSI周期。4组的临床妊娠率分别为35.7%,68.9%,69.6%,66.2%,差异无统计学意义。4组的胚胎种植率分别为25%,53.1%,53.1%,50.8%,具有统计学差异。总体分组A型内膜的临床妊娠率和胚胎种植率均高于B型内膜(P<0.05)。在1、2和4亚组中,不同子宫内膜形态组的妊娠率和种植率无明显差异,但在第3组(内膜12～14 mm),A型内膜妊娠率和胚胎种植率明显高于B型(P<0.001)。结论子宫内膜形态对于IVF/ICSI结局的预测比单纯子宫内膜厚度的预测更有意义,联合两项指标能更好预测IVF妊娠结局。Objective The assessment of endometrial thickness and pattern on clinical outcome in patients undergoing in vitro fertiliza- tion/intracytoplasmic sperm injection and embryo transfer （ IVF/ICSI - ET）. Methods Cycles of IVF/ICSI - ET conducted between January 2011 and December 2011 at Nanjing Drum Tower Hospital were reviewed retrospectively. Endometrial ultrasonographic characteristics were recorded on the day of hCG administration. In the combined analysis, endometrial thickness groups （group 1 ： equal or 〈 8 mm; group 2：9 -11 mm; group 3：12 - 14 mm, group 4： equal or 〉 15 mm） were subdivided into two endometrial patterns （pattern A： triple - line; pattern B： no - triple line）. Clinical outcomes such as implantation and clinical pregnancy rates were analyzed. Results A total of 520 cycles were reviewed. Clinical pregnancy rate （CPR） was 35.7%, 68.9%, 69.6%, 66.2% （ P 〉0.05） respectively, implantation rate was 25.0%, 53.1%, 53.1%, 50. 8 % （ P 〈 0. 05 ） respectively. Among those with pattern A, the clinical pregnancy rate and implantation rate were significantly higher than women with pattern B. In groups 1,2 and 4, clinical pregnancy and implantation rates did not show any significant differences between different endometrial patterns, whereas in group 3, the clinical pregnancy rate and implantation rate in women with pattern A were significantly higher than those with pattern B （ P 〈 0.01 ）. Conclusion Combined analysis of endometrial thickness and pattern on the day of hCG administration was a better predictor of the outcome of IVF/ICSI - ET and may be more helpful for patient counseling than the separate analyses.

关 键 词：体外受精 单精子注射-胚胎移植 子宫内膜厚度 子宫内膜形态 临床妊娠率 胚胎种植率 

分 类 号：R714.8[医药卫生—妇产科学]