Nottingham University NHS Trust, Queens Medical Campus, Nottingham, UK.
Department of Obstetrics and Gynecology, Medical School of Ribeirao Preto, University of Sao Paulo (DGO-FMRP-USP), Ribeirao Preto, Brazil; Ultrasonography and Retraining Medical School of Ribeirao Preto (EURP), Ribeirao Preto, Brazil.
Reprod Biomed Online. 2014 Mar;28(3):343-51. doi: 10.1016/j.rbmo.2013.11.004. Epub 2013 Nov 22.
This study evaluated whether 3D power Doppler (3DPD) indices from endometrium and subendometrium can identify increases in endometrial volume/vascularity induced by exogenous oestradiol and subsequent introduction of progestogens in women undergoing frozen-thawed embryo transfer (FET). Oral oestradiol was administered at increasing doses after down-regulation to prepare the endometrium and progestogens were used for luteal support. 3DPD data sets were acquired at down-regulation, on days 5, 10 and 15 of oestradiol administration and at the time of FET. Endometrial thickness was measured using the multiplanar method and endometrial volume and blood flow from the endometrium and subendometrium were estimated using virtual organ computer-aided analysis and shell-imaging. This study evaluated 45 women at least once: 19 achieved clinical pregnancy (CP); 21 were evaluated at down-regulation (eight CP), 26 at day 5 (10 CP), 31 at day 10 (12 CP), 31 at day 15 (13 CP) and 16 at FET (seven CP). Changes were observed in all parameters between the examinations; however, differences between women who achieved CP and those who did not were not significant. 3DPD angiography is not a sufficiently sensitive tool to predict the outcome of FET. We evaluate whether 3D ultrasound using power Doppler (3DPD) indices from endometrium and subendometrium can identify predictable increases in endometrial volume and vascularity induced by serial increments in exogenous oestradiol and the subsequent introduction of progestogens in women undergoing frozen-thawed embryo transfer (FET) using hormone replacement therapy to prepare the endometrium. Oral oestradiol was administered at increasing doses after down-regulation to prepare the endometrium and progestogens were used for luteal support. 3DPD data sets of the uterus were acquired at down-regulation, on days 5, 10, and 15 of oestradiol administration, and at the time of FET. Endometrial thickness was measured. Endometrial volume and blood flow from the endometrium and subendometrium were measured using virtual organ computer-aided analysis (VOCAL) and shell imaging. This study evaluated 45 women at least once: 19 achieved clinical pregnancy (CP); 21 were evaluated at down-regulation (eight CP), 26 at day 5 (10 CP), 31 at day 10 (12 CP), 31 at day 15 (13 CP) and 16 at FET (seven CP). Changes were observed in all the parameters between the examinations; however, differences between women who achieved CP and those who did not were not significant, suggesting that quantitative 3D power Doppler angiography is not a sufficiently sensitive tool to predict the outcome of FET treatment.
本研究旨在评估经阴道三维能量多普勒（3DPD）指数能否识别接受冻融胚胎移植（FET）的患者中，外源性雌激素诱导的子宫内膜体积/血管增加，以及随后引入孕激素支持黄体。在下调后，口服雌激素逐渐增加剂量以准备子宫内膜，并使用孕激素支持黄体。在下调时、雌激素给药的第 5、10 和 15 天以及 FET 时采集 3DPD 数据集。使用多平面法测量子宫内膜厚度，使用虚拟器官计算机辅助分析（VOCAL）和壳成像法测量子宫内膜和子宫基层的子宫内膜体积和血流。本研究至少评估了 45 名妇女一次：19 名妇女获得临床妊娠（CP）；21 名妇女在下调时（8 名 CP）、26 名妇女在第 5 天（10 名 CP）、31 名妇女在第 10 天（12 名 CP）、31 名妇女在第 15 天（13 名 CP）和 16 名妇女在 FET 时（7 名 CP）接受了评估。在这些检查之间，所有参数都发生了变化；然而，获得 CP 的妇女和未获得 CP 的妇女之间的差异没有统计学意义。3DPD 血管造影术不是一种足够敏感的工具，无法预测 FET 的结果。我们评估经阴道三维能量多普勒（3DPD）指数是否能识别出子宫内膜体积和血管的可预测增加，这些增加是由外源性雌激素的递增剂量诱导的，以及在接受冻融胚胎移植（FET）的患者中，使用激素替代疗法（HRT）准备子宫内膜时，随后引入孕激素支持黄体。在下调后，口服雌激素逐渐增加剂量以准备子宫内膜，并使用孕激素支持黄体。在下调时、雌激素给药的第 5、10 和 15 天以及 FET 时采集子宫的 3DPD 数据集。测量子宫内膜厚度。使用虚拟器官计算机辅助分析（VOCAL）和壳成像法测量子宫内膜和子宫基层的子宫内膜体积和血流。本研究至少评估了 45 名妇女一次：19 名妇女获得临床妊娠（CP）；21 名妇女在下调时（8 名 CP）、26 名妇女在第 5 天（10 名 CP）、31 名妇女在第 10 天（12 名 CP）、31 名妇女在第 15 天（13 名 CP）和 16 名妇女在 FET 时（7 名 CP）接受了评估。在这些检查之间，所有参数都发生了变化；然而，获得 CP 的妇女和未获得 CP 的妇女之间的差异没有统计学意义，这表明定量 3D 能量多普勒血管造影术不是一种足够敏感的工具，无法预测 FET 治疗的结果。
