经阴道三维超声能量彩色多普勒检测子宫内膜及子宫内膜下血流参数在体外受精-冻融胚胎移植中的应用价值  

The Value of Transvaginal Three-dimensional Ultrasound Energy Color Doppler Detection of Endometrial and Subendometrial Blood Flow Parameters in In Vitro Fertilization-frozen-thawed Embryo Transfer

作　　者：巫晶晶 刘玉君 黄柳静 Wu Jingjing;Liu Yujun;Huang Liujing(Nanning Second People's Hospital,Nanning 530000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]南宁市第二人民医院,广西壮族自治区南宁530000

出　　处：《中外医药研究》2023年第14期130-132,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:分析经阴道三维超声能量彩色多普勒检测对子宫内膜及子宫内膜下血流参数在预测体外受精-冻融胚胎移植妊娠结局中的价值。方法:选取2020年3月—2022年3月在南宁市第二人民医院生殖医疗中心行冻融胚胎移植周期的患者143例为研究对象,根据患者是否妊娠分为妊娠组(74例)和未孕组(69例)。比较两组冻融胚胎移植周期中自然周期排卵日或人工周期黄体酮转换日的子宫内膜厚度、子宫内膜三维容积、子宫内膜动脉血流动力学指数、内膜及内膜下三维容积血流指数(FI)。结果:妊娠组子宫内膜厚度高于未孕组,子宫内膜FI VI、VFI及子宫内膜下FI VI、FI、VFI均大于未孕组,差异有统计学意义(P<0.05);子宫内膜厚度预测妊娠的ROC曲线下面积为0.606(P=0.028)。结论:在冻融胚胎移植周期中,子宫内膜容积、子宫内膜动脉动力学指数、子宫内膜及内膜下三维容积FI不能作为预测妊娠结局的可靠指标,但能作为评估内膜血供改善情况的有效指标。当患者进入移植周期时,可行经阴道超声检查,在子宫内膜动脉动力学参数较低,子宫内膜三维容积子宫内膜和子宫内膜下三维容积FI高时,则可考虑在本次月经周期或下个月经周期进行冻融胚胎移植。当数值结果不理想时,可借助药物治疗或其他方式对子宫内膜局部血流灌注改变后再行胚胎移植,进而提供合适的妊娠机会。Objective:To analyze the value of transvaginal three-dimensional ultrasound energy color Doppler detection on endometrial and sub-endometrial blood flow parameters in predicting pregnancy outcome of in vitro fertilization-frozen-thawed embryo transfer.Methods:One hundred and forty-three patients who underwent frozen-thawed embryo transfer cycles at the Reproductive Medical Center of Nanning Second People's Hospital from March 2020 to March 2022 were selected for the study,and were divided into the pregnant group(seventy-four cases)and the non-pregnant group(sixty-nine cases)according to whether they were pregnant or not.Endometrial thickness,endometrial three-dimensional volume,endometrial artery hemodynamic index,and endometrial and sub-endometrial three-dimensional volume flow index(FI)were compared between the two groups on the day of ovulation in the natural cycle or on the day of progesterone conversion in the artificial cycle in the frozen-thawed embryo transfer cycle.Results:Endometrial thickness was higher in the pregnant group than in the non-pregnant group,and endometrial FI VI and VFI and sub-endometrial FI VI,FI,and VFI were greater than those in the non-pregnant group,and the difference was statistically significant(P<0.05);The area under the ROC curve for endometrial thickness to predict pregnancy was 0.606(P=0.028).Conclusion:Endometrial volume,endometrial arterial kinetic index,endometrial and sub-endometrial three-dimensional volume FI cannot be used as a reliable predictor of pregnancy outcome in frozen-thawed embryo transfer cycles,but can be an effective indicator to assess the improvement of endometrial blood supply.When patients enter the transplant cycle,transvaginal ultrasound examination is feasible,when the endometrial artery kinetic parameters are low and the endometrial volume is high,freeze-thaw embryo transfer can be considered in this menstrual cycle or the next menstrual cycle.When the numerical results are unsatisfactory,embryo transfer can be performed with the help of medication

关 键 词：体外受精-冻融胚胎移植 经阴道三维超声能量彩色多普勒 妊娠 

分 类 号：R71[医药卫生—妇产科学]