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目的:探讨卵巢血流变化与卵子质量、胚胎质量的关系。方法:在体外受精-胚胎移植(IVF-ET)过程中应用阴道彩色多普勒超声成像技术(TV-CDS)监测人绒毛膜促性腺激素(hCG)注射日双侧卵巢动脉血流的收缩期与舒张末期流速比值(S/D)、阻力指数(RI)、搏动指数(PI)的变化,分析行IVF-ET治疗的82例患者,获得159组血流指数数据(因为有5例患者只有一侧卵巢有成熟卵泡)。根据S/D、RI、PI不同值分组,A组:S/D≤2.0,B组:S/D=2.1~2.9,C组:S/D≥3.0;D组:RI≤0.50,E组:RI=0.51~0.69,F组:RI≥0.70;G组:PI≤1.00,H组:PI=1.01~1.49,I组:PI≥1.50。分别比较各组间获卵数,获卵率、MⅡ卵数、受精率、卵裂率及优质胚胎数。结果:C组的获卵数、获卵率、MⅡ卵数、受精率均高于A组和B组,但无统计学差异(P>0.05);B组的卵裂率及优质胚胎数均高于A组和C组,但无统计学差异(P>0.05)。F组的获卵数、获卵率、MⅡ卵数均高于D组和E组,但无统计学差异(P>0.05)。E组的受精率、卵裂率及优质胚胎数均高于D组和F组,差异无统计学意义(P>0.05)。I组的获卵率高于G组和H组,与G组相比,有统计学差异(P<0.05)。H组的优质胚胎数明显高于G组和I组,差异有统计学意义(P<0.05);H组的获卵数、MⅡ卵数及受精率均高于G组和I组,但无统计学差异(P>0.05)。G组的卵裂率高于H组和I组,但无统计学差异(P>0.05)。结论:hCG注射日卵巢血流PI与获卵率及优质胚胎数有密切关系。
Objective: To investigate the relationship between ovarian blood flow changes and egg quality and embryo quality. Methods: The systolic phase of bilateral ovarian artery blood flow on human chorionic gonadotropin (hCG) injection was monitored by color Doppler ultrasonography (TV-CDS) during in vitro fertilization-embryo transfer (IVF-ET) (S / D), resistance index (RI) and pulsatility index (PI) were analyzed in 82 patients with IVF-ET and 159 blood flow index data were obtained (since 5 patients had only Ovarian side of a mature follicle). Group A: S / D≤2.0, Group B: S / D = 2.1 ~ 2.9, Group C: S / D≥3.0, Group D: RI≤0.50, Group E according to different values of S / D, : RI = 0.51 ~ 0.69, F group: RI≥0.70; G group: PI≤1.00, H group: PI = 1.01 ~ 1.49, I group: PI≥1.50. The number of oocytes, the number of oocytes, the number of M Ⅱ oocytes, the fertilization rate, the cleavage rate and the number of high quality embryos were compared among the groups. Results: The number of oocytes, the number of oocytes retrieved, the number of MⅡ oocytes and the fertilization rate in group C were higher than those in group A and group B, but there was no significant difference (P> 0.05). The cleavage rate and number of high quality embryos Higher than A group and C group, but no statistical difference (P> 0.05). The number of oocytes, the number of oocytes retrieved and the number of MII oocytes in group F were higher than those in group D and group E, but there was no significant difference (P> 0.05). The fertilization rate, cleavage rate and the number of high quality embryos in group E were higher than those in group D and group F, with no significant difference (P> 0.05). The ovulation rate of group I was higher than that of group G and H, which was significantly different from that of group G (P <0.05). The number of high-quality embryos in group H was significantly higher than that in group G and group I (P <0.05). The number of oocytes, number of MⅡ oocytes and fertilization rate in group H were higher than those in group G and group I Statistical difference (P> 0.05). The cleavage rate of G group was higher than that of H group and I group, but there was no significant difference (P> 0.05). Conclusion: The ovarian blood flow PI on the day of hCG injection is closely related to the rate of ovulation and the number of high quality embryos.