Son Jung Bin, Jeong Ju Eun, Joo Jong Kil, Na Yong Jin, Kim Chang Woon, Lee Kyu Sup
Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Busan.
J Obstet Gynaecol Res. 2014 Jun;40(6):1661-7. doi: 10.1111/jog.12406.
An appropriate endometrial condition and vascular supply are usually considered essential for implantation of an embryo. This study was performed to assess the role of endometrial and uterine vascularity status measurement in predicting pregnancy outcome during frozen-thawed embryo transfer cycles.
A total of 70 infertile women were recruited with controlled ovarian stimulation followed by oocyte retrieval. After in vitro fertilization or intracytoplasmic sperm injection, embryos were cultured to blastocysts and blastocysts with good quality were selected for cryopreservation. After endometrial preparation, vitrified blastocysts were thawed and assisted hatching by zona dissection was performed. On the day of embryo transfer, endometrial thickness (EMT), resistance index (RI) and pulsatility index (PI) of sub-endometrial artery (SEA) and uterine artery (UA) were obtained by transvaginal sonography. The women were divided into the pregnant and non-pregnant groups, and these variables were compared between the two groups.
Patients' general demographic characteristics were not statistically different between the pregnant and non-pregnant groups. The overall implantation rate, clinical pregnancy rate, and ongoing pregnancy rate were 31.1%, 41.4% and 28.6%, respectively. Twenty-nine patients who conceived had average EMT, RI of SEA, PI of SEA, RI of UA, and PI of UA values of 9.15 mm, 0.91, 2.42, 0.95, and 3.37, respectively. Forty-one patients who did not conceive had average EMT, RI of SEA, PI of SEA, RI of UA, and PI of UA values of 9.31 mm, 1.01, 2.56, 0.94, and 3.00, respectively. In the two groups, none of the variables was statistically different (P > 0.05).
EMT and blood flow index of endometrium and uterus measured by transvaginal sonography are not an effective predictor of pregnancy outcome in frozen-thawed embryo transfer cycles.
合适的子宫内膜条件和血管供应通常被认为是胚胎着床的必要条件。本研究旨在评估子宫内膜和子宫血管状态测量在预测冻融胚胎移植周期妊娠结局中的作用。
共招募70名不孕妇女,进行控制性卵巢刺激后取卵。体外受精或卵胞浆内单精子注射后,将胚胎培养至囊胚,选择质量良好的囊胚进行冷冻保存。子宫内膜准备后,解冻玻璃化囊胚并进行激光辅助孵化。胚胎移植当天,通过经阴道超声测量子宫内膜厚度(EMT)、子宫内膜下动脉(SEA)和子宫动脉(UA)的阻力指数(RI)和搏动指数(PI)。将妇女分为妊娠组和非妊娠组,比较两组之间的这些变量。
妊娠组和非妊娠组患者的一般人口统计学特征无统计学差异。总体着床率、临床妊娠率和持续妊娠率分别为31.1%、41.4%和28.6%。29名受孕患者的平均EMT、SEA的RI、SEA的PI、UA的RI和UA的PI值分别为9.15mm、0.91、2.42、0.95和3.37。41名未受孕患者的平均EMT、SEA的RI、SEA的PI、UA的RI和UA的PI值分别为9.31mm、1.01、2.56、0.94和3.00。两组之间,这些变量均无统计学差异(P>0.05)。
经阴道超声测量的子宫内膜和子宫的EMT及血流指数不是冻融胚胎移植周期妊娠结局的有效预测指标。