The Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Front Endocrinol (Lausanne). 2024 Apr 15;15:1278504. doi: 10.3389/fendo.2024.1278504. eCollection 2024.
The objective was to analyze the impact of the uterine artery pulsatility index (PI) on pregnancy outcomes by measuring uterine artery blood flow on the day of endometrial transformation in patients undergoing frozen-thawed embryo transfer (FET).
This was a case-control study. In total, 2,036 patients who underwent FET at the Third Affiliated Hospital of Zhengzhou University from October 2019 to September 2020 were included. The patients were divided into a clinical pregnancy group and a nonclinical pregnancy group according to pregnancy outcome. A multivariate logistic regression model was used to analyze the factors affecting the clinical pregnancy rate. The receiver operating characteristic (ROC) curve was used to determine the optimal mean PI cutoff value of 1.75. After 1:1 propensity score matching (PSM), 562 patients were included. For statistical description and analysis, the patients were divided into two groups: a group with a mean PI > 1.75 and a group with a mean PI ≤ 1.75.
The clinical pregnancy group included 1,218 cycles, and the nonclinical pregnancy group included 818 cycles. There were significant differences in female age (P<0.01), infertility type (P=0.04), baseline follicle-stimulating hormone level (P=0.04), anti-Müllerian hormone (AMH) level (P<0.01), antral follicle count (P<0.01), number of transferred embryos (P=0.045) and type of transferred embryo (P<0.01). There was no significant difference in the mean bilateral PI (1.98 ± 0.34 vs. 1.95 ± 0.35, P=0.10). The multivariate analysis results showed that maternal age (AOR=0.95, 95% CI=0.93-0.98, P<0.01), AMH level (AOR=1.00, 95% CI=1.00-1.01, P=0.045), number of transferred embryos (AOR=1.98, 95% CI=1.47-2.70, P<0.01), and type of transferred embryo (AOR=3.10, 95% CI=2.27-4.23, P<0.01) were independent factors influencing the clinical pregnancy rate. The mean PI (AOR=0.85, 95% CI=0.70-1.05; P=0.13) was not an independent factor influencing the clinical pregnancy rate. Participants were divided into two groups according to the mean PI cutoff value of 1.75, and there was no significant difference between the two groups (P > 0.05).
In this study, we found that the uterine artery PI on the day of endometrial transformation in patients undergoing FET is not a good predictor of pregnancy outcomes.
分析在接受冻融胚胎移植（FET）的患者中，于子宫内膜转化日测量子宫动脉血流，通过子宫动脉搏动指数（PI）来分析对妊娠结局的影响。
这是一项病例对照研究。2019 年 10 月至 2020 年 9 月期间，郑州大学第三附属医院共纳入 2036 名接受 FET 的患者。根据妊娠结局将患者分为临床妊娠组和非临床妊娠组。采用多变量 logistic 回归模型分析影响临床妊娠率的因素。采用受试者工作特征（ROC）曲线确定 1.75 的平均 PI 最佳截断值。经过 1：1 倾向评分匹配（PSM）后，纳入 562 名患者。为了进行统计描述和分析，将患者分为两组：平均 PI>1.75 组和平均 PI≤1.75 组。
临床妊娠组包括 1218 个周期，非临床妊娠组包括 818 个周期。两组间女性年龄（P<0.01）、不孕类型（P=0.04）、基础卵泡刺激素水平（P=0.04）、抗苗勒管激素（AMH）水平（P<0.01）、窦卵泡计数（P<0.01）、移植胚胎数（P=0.045）和移植胚胎类型（P<0.01）均有显著差异。双侧 PI 的平均值无显著差异（1.98±0.34 比 1.95±0.35，P=0.10）。多变量分析结果显示，母亲年龄（OR=0.95，95%CI=0.93-0.98，P<0.01）、AMH 水平（OR=1.00，95%CI=1.00-1.01，P=0.045）、移植胚胎数（OR=1.98，95%CI=1.47-2.70，P<0.01）和移植胚胎类型（OR=3.10，95%CI=2.27-4.23，P<0.01）是影响临床妊娠率的独立因素。平均 PI（OR=0.85，95%CI=0.70-1.05；P=0.13）不是影响临床妊娠率的独立因素。根据平均 PI 截断值 1.75 将患者分为两组，两组间无显著差异（P>0.05）。
本研究发现，FET 患者子宫内膜转化日的子宫动脉 PI 不是预测妊娠结局的良好指标。
