Wang Jianing, Xia Fei, Zhou Ying, Wei Xuedong, Zhuang Yanyan, Huang Yingxue
Reproductive Center, First Affiliated Hospital of Soochow University, Suzhou, China.
Medical College of Soochow University, Suzhou, China.
J Ultrasound Med. 2018 Jan;37(1):149-163. doi: 10.1002/jum.14319. Epub 2017 Jul 17.
To examine the association between endometrial/subendometrial vasculature and in vitro fertilization-embryo transfer (IVF-ET) and frozen embryo transfer (FET) outcomes.
A meta-analysis of studies using endometrial/subendometrial 3-dimensional ultrasound and power Doppler angiography was performed to examine the vascularization index (VI), flow index (FI), and vascularization-flow index (VFI) in pregnant and nonpregnant women. Ten articles were analyzed, including 895 pregnant women and 882 nonpregnant women.
A subgroup analysis of the measuring time showed that the endometrial VI (standardized mean difference [SMD], 0.57; 95% confidence interval [CI], 0.40, 0.74; P < .00001), FI (SMD, 0.56; 95% CI, 0.33, 0.78; P < .00001), and VFI (SMD, 0.45; 95% CI, 0.28, 0.61; P < .00001) measured on the ET day, but not on the human chorionic gonadotropin (hCG) trigger day, were significantly higher in pregnant than nonpregnant women. Additionally, the subendometrial FI was significantly increased in pregnant women on the both hCG day (SMD, 0.68; 95% CI, 0.31, 1.06; P = .004) and ET day (SMD, 0.30; 95% CI, 0.08, 0.52; P = .007). A subgroup analysis of cycle type showed that the endometrial VI (SMD, 0.52; 95% CI, 0.30, 0.74; P < .00001), FI (SMD, 0.44; 95% CI, 0.22, 0.66; P = .0001), and VFI (SMD, 0.45; 95% CI, 0.23, 0.67; P = .03) on the ET day were significantly increased in pregnant women in the FET subgroup.
The subendometrial FI on the hCG day and endometrial VI, FI, and VFI on the ET day are potentially associated with pregnancy occurrence during IVF-ET. The endometrial VI, FI, and VFI could help identify appropriate timing for FET. However, the accuracy of these indices in predicting pregnancy occurrence must be further evaluated in additional large-scale studies.
探讨子宫内膜/子宫内膜下血管系统与体外受精-胚胎移植（IVF-ET）及冷冻胚胎移植（FET）结局之间的关联。
对使用子宫内膜/子宫内膜下三维超声和能量多普勒血管造影的研究进行荟萃分析，以检查孕妇和未孕女性的血管化指数（VI）、血流指数（FI）和血管化-血流指数（VFI）。分析了10篇文章，包括895名孕妇和882名未孕女性。
测量时间的亚组分析显示，在胚胎移植日而非人绒毛膜促性腺激素（hCG）触发日测量的子宫内膜VI（标准化均数差[SMD]，0.57；95%置信区间[CI]，0.40，0.74；P < .00001）、FI（SMD，0.56；95%CI，0.33，0.78；P < .00001）和VFI（SMD，0.45；95%CI，0.28，0.61；P < .00001），孕妇显著高于未孕女性。此外，在hCG日（SMD，0.68；95%CI，0.31，1.06；P = .004）和胚胎移植日（SMD，0.30；95%CI，0.08，0.52；P = .007），孕妇的子宫内膜下FI均显著升高。周期类型的亚组分析显示，在FET亚组中，胚胎移植日的子宫内膜VI（SMD，0.52；95%CI，0.30，0.74；P < .00001）、FI（SMD，0.44；95%CI，0.22，0.66；P = .0001）和VFI（SMD，0.45；95%CI，0.23，0.67；P = .03）在孕妇中显著升高。
hCG日的子宫内膜下FI以及胚胎移植日的子宫内膜VI、FI和VFI可能与IVF-ET期间的妊娠发生有关。子宫内膜VI、FI和VFI有助于确定FET的合适时机。然而，这些指标在预测妊娠发生方面的准确性必须在更多大规模研究中进一步评估。
