Department of Reproductive Medicine, Xiangya Hospital, Central-south University, Changsha City, Hunan Province, PR China.
Hum Reprod. 2012 Sep;27(9):2684-9. doi: 10.1093/humrep/des257. Epub 2012 Jul 14.
Is there a difference in the characteristics of uterine peristalsis in natural and controlled ovarian hyperstimulation (COH) cycles?
COH significantly changed the uterine peristaltic pattern.
In natural menstrual cycles, the periodic changes of uterine peristalsis are closely related to the reproductive process.
STUDY DESIGN, SIZE, DURATION: This is a prospective cohort study with a total of 64 subjects involved. The study was performed between May 2011 and August 2011.
PARTICIPANTS/MATERIALS, SETTING, METHODS: Sixty-four infertile women with regular, ovulatory menstrual cycles underwent follicular tracking in one natural cycle and after ovarian stimulation (GnRH-agonist down-regulation) in the subsequent cycle (COH). Three time points were studied in both cycles: at LH surge/HCG plus 1 day, ovulation/oocyte retrieval and 2 days after ovulation/retrieval. The study was performed in an IVF center of the university-affiliated Xiangya hospital.
Uterine peristaltic wave frequency was 1.31 times higher in the COH than in the natural cycle (P< 0.01). At all three time points in the COH cycle, waves moving from the cervix to fundus dominated, comprising 80-90% of the wave types observed, while 'no activity' was more frequently observed in the natural cycle. The wave frequency was positively correlated with the level of serum estradiol (E(2)) (r= 0.30; P< 0.01) and negatively correlated with the progesterone level (r= -0.48; P< 0.01) for the physiological range of steroid levels. No correlation was found between the wave frequency and supraphysiological concentrations of E(2) or progesterone.
LIMITATIONS, REASONS FOR CAUTION: The two observers were not independent and this was a limitation of the study. Quantitative measurements of wave amplitude in the different cycles should be compared in future research.
Uterine peristalsis was much higher in the COH cycle than in the natural cycle. The endometrial movements did not weaken to the natural level before embryo transfer, even with high levels of progesterone. The wave frequency was positively correlated with serum E(2) level and negatively correlated with that of progesterone within the physiological range. No correlation was found between the wave frequency and supraphysiological concentrations of E(2) and progesterone.
自然和控制性卵巢过度刺激（COH）周期中子宫蠕动的特征是否存在差异？
COH 显著改变了子宫蠕动模式。
在自然月经周期中，子宫蠕动的周期性变化与生殖过程密切相关。
研究设计、规模、持续时间：这是一项前瞻性队列研究，共涉及 64 名受试者。该研究于 2011 年 5 月至 2011 年 8 月进行。
参与者/材料、地点、方法：64 名月经周期规律、排卵正常的不孕妇女在一个自然周期中进行卵泡监测，随后在下一个周期（COH）中进行卵巢刺激（GnRH 激动剂下调）。在两个周期的三个时间点进行研究：LH 峰/HCG 加 1 天、排卵/取卵和排卵/取卵后 2 天。该研究在湘雅医院附属大学的 IVF 中心进行。
COH 中子宫蠕动波频率比自然周期高 1.31 倍（P<0.01）。在 COH 周期的所有三个时间点，从宫颈向子宫底移动的波占主导地位，占观察到的波型的 80-90%，而“无活动”在自然周期中更为常见。波的频率与血清雌二醇（E2）水平呈正相关（r=0.30；P<0.01），与孕激素水平呈负相关（r=-0.48；P<0.01），处于生理类固醇水平范围内。在超生理浓度的 E2 或孕激素水平下，未发现波频率与波频率之间存在相关性。
局限性、谨慎的原因：两名观察者并非独立，这是研究的一个局限性。在未来的研究中，应比较不同周期中波幅的定量测量值。
COH 周期中子宫蠕动明显高于自然周期。即使孕激素水平较高，子宫内膜运动也不会减弱到自然水平，然后再进行胚胎移植。波的频率与血清 E2 水平呈正相关，与孕激素水平呈负相关，处于生理范围内。在超生理浓度的 E2 和孕激素水平下，未发现波频率与波频率之间存在相关性。
