Raine-Fenning N J, Campbell B K, Kendall N R, Clewes J S, Johnson I R
Academic Division of Reproductive Medicine, School of Human Development, University of Nottingham, Nottingham, UK.
Hum Reprod. 2004 Nov;19(11):2605-14. doi: 10.1093/humrep/deh459. Epub 2004 Oct 1.
We used three-dimensional power Doppler angiography (3D-PDA) to examine the periodic changes in endometrial development and subendometrial vascularity during the normal menstrual cycle in 29 women with unexplained subfertility and 19 controls.
3D-PDA was performed on alternate days from day 3 of the cycle until ovulation and then every 4 days until menses. VOCAL (Virtual Organ Computer-aided AnaLysis) and shell-imaging were used to define and to quantify the power Doppler signal within the endometrial and subendometrial regions producing indices of their relative vascularity.
Women with unexplained subfertility demonstrated significant changes with time (P<0.001) in the indices of vascularity within the endometrium and subendometrium during the menstrual cycle characterized by a pre-ovulatory peak and post-ovulatory fall. These changes mirrored those observed in the control group but were significantly reduced in the endometrium and subendometrium during the mid-late follicular phase and early luteal phase. There were no differences in endometrial thickness or volume between the groups or in the plasma concentrations of estradiol or progesterone.
Endometrial and subendometrial vascularity are significantly reduced in women with unexplained subfertility during the mid-late follicular phase irrespective of estradiol or progesterone concentrations and endometrial morphometry.
我们使用三维能量多普勒血管造影（3D-PDA）检查了29例不明原因不孕症女性和19例对照者在正常月经周期中子宫内膜发育及内膜下血管的周期性变化。
在月经周期第3天开始隔日进行3D-PDA检查，直至排卵，然后每4天检查一次直至月经来潮。使用VOCAL（虚拟器官计算机辅助分析）和壳层成像来定义和量化子宫内膜及内膜下区域内的能量多普勒信号，得出其相对血管指数。
不明原因不孕症女性在月经周期中，子宫内膜和内膜下血管指数随时间有显著变化（P<0.001），其特征为排卵前达到峰值，排卵后下降。这些变化与对照组相似，但在卵泡中晚期和黄体早期，子宫内膜和内膜下的变化明显减弱。两组间子宫内膜厚度或体积以及雌二醇或孕酮的血浆浓度均无差异。
不明原因不孕症女性在卵泡中晚期，无论雌二醇或孕酮浓度及子宫内膜形态如何，其子宫内膜和内膜下血管均显著减少。
