不孕患者移植当日子宫内膜容受性评估对临床妊娠率影响研究  

Effect of endometrial receptivity evaluation on clinical pregnancy rate in infertile patients on the day of transplantation

作　　者：李芷舒 鲁海鸥 张宇明 王英华 于月新 LI Zhi-shu;LU Hai-ou;ZHANG Yu-ming;WANG Ying-hua;YU Yue-xin(Center for Reproductive Medicine,General Hospital of Northern Theater Command,Shenyang 110000,China)

机构地区：[1]北部战区总医院生殖医学中心,辽宁沈阳110000

出　　处：《中国实用妇科与产科杂志》2020年第3期264-266,共3页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨移植当日体外受精/卵胞浆内单精子注射-胚胎移植(IVF/ICSI-ET)不孕患者子宫内膜容受性对患者妊娠率的影响。方法选择2017年1月至2018年1月在北部战区总医院接受IVF/ICSI-ET辅助生殖技术的1325例不孕患者,在移植当日行经阴道三维超声检查以获得子宫内膜容受性相关参数,根据最终妊娠结局,分为妊娠组(909例)与非妊娠组(416例),分析两组超声参数,探讨各项指标与妊娠结局的关系。结果妊娠组与非妊娠组患者年龄分别为(33.41±3.85)岁、(35.27±4.75)岁;移植当日内膜厚度分别为(0.96±0.20)mm、(0.93±0.22)mm,两组比较差异均有统计学意义(P<0.05);妊娠组子宫内膜下血流分支[(8.00±1.66)支]明显多于非妊娠组[(7.08±1.69)支],差异有统计学意义(P<0.05);子宫内膜动脉与子宫动脉的阻力指数(RI)、搏动指数(PI)、收缩峰值血流速度与舒张末期血流速度比值(S/D)比较,差异均无统计学意义(P>0.05)。结论移植当日在三维超声下进行子宫内膜容受性评估对预测不孕患者临床妊娠结局有一定的参考价值。Objective To investigate the effect of endometrial receptivity on embryo pregnancy rate of infertile patients with in vitro fertilization/follicular intrauterine single sperm microinjection-embryo transfer(IVF/ICSI-ET) on the day of transplantation.Methods 1325 cases of I VF/ICSI-ET assisted pregnancy patients were selected for transvaginal threedimensional ultrasonography on the day of transplantation to obtain relevant parameters of endometrial receptivity.According to the final pregnancy outcome,909 patients in the clinical pregnancy group and 416 patients in the nonpregnancy group were compared to analyze the relationship between various ultrasound parameters and pregnancy outcome.Results The age of patients in the pregnancy group and non-pregnancy group was(33.41±3.85) and(35.27±4.75) years old,respectively,and the difference between the two groups was statistically significant(P<0.05).Endometrial thickness on the day of transplantation was(0.96±0.20)and(0.93±0.22) mm,respectively,in the pregnant group and the non-pregnant group,and the difference was statistically significant(P<0.05).The subendometrial blood flow branches of the pregnant group were significantly more than those of the non-pregnant group,and the difference was statistically significant(P <0.05).There was no statistically significant difference(P> 0.05) in the ratio of resistance index(RI),pulse index(PI),or the S/D ratio between endometrial artery and uterine artery.Conclusion Threedimensional ultrasonographic assessment of endometrium receptivity on the day of transplantation has a certain reference value for the prediction of clinical pregnancy outcome.

关 键 词：三维多普勒超声 体外受精 卵胞浆内单精子注射 子宫内膜容受性 血流参数 妊娠结局 

分 类 号：R321-33[医药卫生—人体解剖和组织胚胎学]