Department of Electrical Engineering, Signal Processing Systems: Biomedical Diagnostics Group, Eindhoven University of Technology, Eindhoven, 19, Flux, Postbus 513 MB 5600, the Netherlands; Department of Reproductive Medicine, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium.
Department of Electrical Engineering, Signal Processing Systems: Biomedical Diagnostics Group, Eindhoven University of Technology, Eindhoven, 19, Flux, Postbus 513 MB 5600, the Netherlands.
Reprod Biomed Online. 2020 Dec;41(6):1045-1053. doi: 10.1016/j.rbmo.2020.08.006. Epub 2020 Aug 18.
Does uterine activity differ in patients who have undergone successful IVF treatment compared with patients who have undergone unsuccessful IVF treatment?
Prospective study of 16 women who underwent fresh single embryo transfer. All patients underwent transvaginal ultrasound in three phases of the IVF treatment: ovarian stimulation 1 h before embryo transfer (ET1) and 5-7 days after embryo transfer (ET5-7). Uterine motion analysis was implemented by a dedicated speckle tracking algorithm; frequency- and amplitude-related features were extracted from the derived signals to characterize the uterine activity in relation to ongoing implantation (positive HCG after 6 weeks) and ongoing pregnancy at 11 weeks.
Uterine activity in terms of frequency (ovarian stimulation ET1, P = 0.04; ovarian stimulation ET5-7, P = 0.002) and amplitude (ovarian stimulation ET1, P = 0.0003; ovarian stimulation ET5-7, P = 0.000008) is significantly higher in the ovarian stimulation phase compared with ET1 and ET5-7. Women with ongoing pregnancies showed significantly higher uterine contraction frequency compared with those with no ongoing pregnancies in all phases (ovarian stimulation, P = 0.006; ET1, P = 0.015; ET5-7, P = 0.007). Uterine contraction amplitude was significantly lower (P = 0.037) in women at ET5-7 in women with ongoing pregnancies.
This study is a first step towards assessing uterine activity during IVF objectively and non-invasively. It is an essential step to understanding the previously suggested effect of contractions on IVF failure. Uterine activity after embryo transfer characterized by high frequency and low amplitude may favour embryo implantation. Research with larger patient cohorts is needed to build on current evidence and knowledge of uterine contractions during IVF.
接受体外受精（IVF）治疗成功的患者与治疗失败的患者的子宫活动是否存在差异？
对 16 名接受新鲜胚胎单移植的女性进行前瞻性研究。所有患者均在 IVF 治疗的三个阶段进行经阴道超声检查：胚胎移植前 1 小时（ET1）和胚胎移植后 5-7 天（ET5-7）。通过专用斑点跟踪算法进行子宫运动分析；从衍生信号中提取与频率和幅度相关的特征，以描述与着床（6 周后 HCG 阳性）和 11 周时持续妊娠相关的子宫活动。
在频率（卵巢刺激 ET1，P=0.04；卵巢刺激 ET5-7，P=0.002）和幅度（卵巢刺激 ET1，P=0.0003；卵巢刺激 ET5-7，P=0.000008）方面，子宫活动在卵巢刺激阶段明显高于 ET1 和 ET5-7。在所有阶段，持续妊娠的女性子宫收缩频率明显高于无持续妊娠的女性（卵巢刺激，P=0.006；ET1，P=0.015；ET5-7，P=0.007）。在持续妊娠的女性中，ET5-7 时的子宫收缩幅度明显较低（P=0.037）。
本研究是客观、非侵入性评估 IVF 期间子宫活动的第一步。这是理解先前提出的收缩对 IVF 失败影响的重要步骤。胚胎移植后以高频率和低幅度为特征的子宫活动可能有利于胚胎着床。需要更大的患者队列研究来建立当前关于 IVF 期间子宫收缩的证据和知识。
