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目的:探讨三维超声在体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSI-ET)中对子宫内膜容受性的评价价值。方法:回顾性分析422例IVF/ICSI助孕患者h CG注射日子宫内膜三维超声参数,将妊娠组与非妊娠组资料进行比较,并进一步根据年龄(<35岁,≥35岁)、内膜体积(<2.5 ml,≥2.5 ml)分层,分析各项超声参数与妊娠结局的关系。结果:妊娠组234例,非妊娠组188例,妊娠组年龄、不孕年限显著低于非妊娠组(P<0.05),内膜体积显著大于非妊娠组(P<0.05),Logistic回归显示年龄及内膜体积对妊娠有预测价值。年龄<35岁时,妊娠组与非妊娠组患者一般资料及各项超声参数均无统计学差异(P>0.05);年龄≥35岁时,妊娠组内膜体积显著大于非妊娠组(P<0.05),一般资料及其它超声参数无统计学差异(P>0.05)。与内膜体积<2.5 ml组相比,内膜体积≥2.5 ml组临床妊娠率及胚胎种植率均显著增加(P<0.05);患者体质量指数(BMI)显著降低(P<0.05),内膜厚度及内膜螺旋动脉血流参数收缩期峰值血流速度(PSV)、舒张期峰值血流速度(EDV)、搏动指数(PI)、阻力指数(RI)、血流指数(FI)均显著增加(P<0.05)。结论:IVF/ICSIET中子宫内膜h CG注射日三维超声测定对内膜容受性的评价具有一定作用,内膜体积对妊娠有预测作用,高龄患者可根据h CG注射日内膜体积慎重选择ET时机,提高妊娠率,避免有限的优质胚胎浪费。
Objective: To evaluate the value of three-dimensional ultrasound in endometrial receptivity in in vitro fertilization / intracytoplasmic sperm injection-embryo transfer (IVF / ICSI-ET). Methods: Three hundred and seventy-four patients with IVF / ICSI were retrospectively analyzed. The endometrial three-dimensional ultrasound parameters at h CG injection day were retrospectively analyzed. The data of pregnancy and non-pregnancy group were compared and further analyzed according to the age (<35 years, ≥35 years) The membrane volume (<2.5 ml, ≥ 2.5 ml) was stratified to analyze the relationship between ultrasound parameters and pregnancy outcome. Results: There were 234 cases of pregnancy and 188 cases of non-pregnancy. The age and length of infertility in pregnancy group were significantly lower than those in non-pregnancy group (P <0.05), and the volume of intima was significantly larger than that in non-pregnancy group (P <0.05). Logistic regression showed that age And endometrial volume of pregnancy have predictive value. There were no significant differences in general data and ultrasound parameters between pregnant women and non-pregnant women at 35 years of age (P> 0.05). At 35 years of age, the intima volume in pregnancy group was significantly larger than that in non-pregnant women (P < 0.05). There was no statistical difference between general information and other ultrasound parameters (P> 0.05). Compared with the intimal volume <2.5 ml group, the clinical pregnancy rate and embryo implantation rate increased significantly (P <0.05), the body mass index (BMI) decreased significantly (P <0.05) Membrane thickness and endometrial spiral arteries parameters: peak systolic velocity (PSV), peak diastolic velocity (EDV), pulsatility index (PI), resistance index (RI) and blood flow index (FI) Increase (P <0.05). Conclusion: The three-dimensional echocardiography of endometrial h CG injection in IVF / ICSIET can play an important role in the evaluation of endometrial receptivity. The volume of endometrium has a predictive value for pregnancy. The elderly patients can be carefully selected according to the volume of endomembrane in h CG injection ET timing, improve pregnancy rates, avoid limited quality embryo waste.