Ohno Y, Fujimoto Y
Kyoto Infertility Center, Japan.
Hum Reprod Update. 1998 Sep-Oct;4(5):560-4. doi: 10.1093/humupd/4.5.560.
The rapid development of ultrasonographic equipment now permits instantaneous assessment of follicles and endometrium. The sonographic appearance of the endometrium has been discussed in relation to in-vitro fertilization (IVF) cycles. However, a generally agreed view of the relationship of the sonographic appearance to fecundity in IVF cycles has not emerged. We have studied the relationship between steroid receptors and the sonographic appearance of the preovulatory endometrium in natural cycles and ovulation induction cycles. Preovulatory endometrial thickness was not found to be indicative of fecundity, although a preovulatory endometrial thickness of <9 mm related to an elevated miscarriage rate. The preovulatory endometrial echo pattern did not predict fecundity. No relationships were found among endometrial appearance, endometrial steroid receptors and steroid hormone concentrations in serum. Oestrogen or progesterone receptor concentrations were not related to endometrial thickness or to concentrations of serum oestradiol, the only significant correlation being found between the endometrial concentrations of oestrogen and progesterone receptors. The ratio of progesterone:oestrogen receptor concentration was somewhat less in echo pattern B (not triple line) endometrium compared with pattern A (triple line) endometrium. Oestrogen and progesterone receptor concentrations appeared stable on gonadotrophin induction, though fewer numbers were found during clomiphene cycles than in natural cycles. With regard to the distribution of receptor concentration between clomiphene and natural cycles, most women using clomiphene had very low oestrogen receptor populations. Pregnancy rates were low, in spite of high ovulatory rates during clomiphene treatment and were mainly related to low oestrogen receptor concentrations in preovulatory endometrium.
超声设备的迅速发展使得现在能够即时评估卵泡和子宫内膜。关于子宫内膜的超声表现，已结合体外受精（IVF）周期进行了讨论。然而，对于IVF周期中超声表现与生育力之间的关系，尚未形成普遍认可的观点。我们研究了自然周期和促排卵周期中类固醇受体与排卵前子宫内膜超声表现之间的关系。尽管排卵前子宫内膜厚度<9 mm与流产率升高相关，但未发现排卵前子宫内膜厚度可指示生育力。排卵前子宫内膜的回声模式无法预测生育力。在子宫内膜外观、子宫内膜类固醇受体与血清类固醇激素浓度之间未发现相关性。雌激素或孕激素受体浓度与子宫内膜厚度或血清雌二醇浓度无关，仅在子宫内膜雌激素和孕激素受体浓度之间发现了显著相关性。与A型（三线型）子宫内膜相比，B型（非三线型）子宫内膜中孕激素：雌激素受体浓度的比值略低。在促性腺激素诱导下，雌激素和孕激素受体浓度似乎稳定，不过在克罗米芬周期中发现的受体数量比自然周期中少。关于克罗米芬周期与自然周期中受体浓度的分布，大多数使用克罗米芬的女性雌激素受体数量非常低。尽管在克罗米芬治疗期间排卵率较高，但妊娠率较低，这主要与排卵前子宫内膜中雌激素受体浓度低有关。
