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子宫腔结构特征对纵隔子宫畸形生殖结局的影响。

The impact of uterine cavity structural features on reproductive outcomes in T-shaped uterine malformation.

作者信息

Tokhunts Karine, Pacheco Luis Alonso, Chopikyan Armine, Khudaverdyan Anna, Abgaryan Nelly, Aleksandryan Knarik, Grigoryan Adrine, Adamyan Marianna

机构信息

Department of Ultrasound in Obstetrics, Gynecology, and Fetal Medicine, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia.

Centro Gutenberg, Unidad De Endoscopia Ginecológica, Hospital Xanit Internacional, Málaga, Spain.

出版信息

J Ultrasound. 2025 Jun;28(2):359-368. doi: 10.1007/s40477-024-00980-y. Epub 2024 Dec 27.

Abstract

OBJECTIVES

Despite advancements in modern medicine, the effectiveness of in vitro fertilization (IVF) remains low. This study aimed to assess the impact of specific features of T-shaped uterine cavity malformation and its intermediate forms on reproductive function and the effectiveness of assisted reproductive technology (ART), particularly on IVF results and pregnancy outcomes.

METHODS

A prospective cohort study included 388 somatically healthy patients undergoing 3D ultrasound (US) examination of the uterine cavity before embryonic transfer for IVF treatment. Patients were evaluated for morphometric parameters using standardized US protocols. Statistical analysis was performed using SPSS statistics.

RESULTS

The study revealed that patients with T-shaped uterus and intermediate forms had higher rates of miscarriages, and unfavorable pregnancy outcomes compared to those with normal uterine cavities. The frequency of pregnancy occurrence in T-shaped and Intermediate groups was statistically similar with the "Normal uterus" group. Morphometric parameters such as T-angle, lateral angle, and myometrial thickness significantly influenced IVF outcomes.

CONCLUSION

The study highlights the importance of morphometric parameters in predicting IVF success and pregnancy outcomes in patients with T-shaped uterine cavity malformation. These parameters can guide clinical decision-making and may serve as predictors for reproductive outcomes in ART procedures. Further research is warranted to validate these findings and explore additional ultrasound markers for better prediction of reproductive outcomes in patients with uterine cavity malformations.

摘要

目的

尽管现代医学取得了进步,但体外受精(IVF)的有效性仍然较低。本研究旨在评估T形子宫腔畸形及其中间形式的特定特征对生殖功能和辅助生殖技术(ART)有效性的影响,特别是对IVF结果和妊娠结局的影响。

方法

一项前瞻性队列研究纳入了388名身体健康的患者,这些患者在进行IVF治疗的胚胎移植前接受了子宫腔的三维超声(US)检查。使用标准化的US方案对患者的形态学参数进行评估。使用SPSS统计软件进行统计分析。

结果

研究表明,与子宫腔正常的患者相比,T形子宫和中间形式的患者流产率更高,妊娠结局不佳。T形组和中间组的妊娠发生率与“正常子宫”组在统计学上相似。T角、侧角和肌层厚度等形态学参数显著影响IVF结果。

结论

该研究强调了形态学参数在预测T形子宫腔畸形患者IVF成功率和妊娠结局方面的重要性。这些参数可以指导临床决策,并可作为ART程序中生殖结局的预测指标。有必要进行进一步的研究来验证这些发现,并探索其他超声标志物,以便更好地预测子宫腔畸形患者的生殖结局。

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本文引用的文献

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A novel mutation of HOXA11 in a patient with septate uterus.患者子宫纵隔中 HOXA11 的一种新突变。
Orphanet J Rare Dis. 2017 Dec 11;12(1):178. doi: 10.1186/s13023-017-0727-9.

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