Chien L W, Tzeng C R, Chang S R, Chen A C
Department of Obstetrics and Gynecology, Taipei Medical College, Taiwan, Republic of China.
Early Pregnancy. 1995 Mar;1(1):27-32.
The influence of uterine blood flow impedance on embryo implantation rate was investigated by transvaginal color Doppler sonography examination before embryo transfer. A total of 108 women undergoing in vitro fertilization (IVF) procedures and who had at least one good quality embryo for transfer to the uterus received Doppler evaluation before embryo transfer. Color flow imaging with blood flow waveform analysis from bilateral uterine arteries was obtained to calculate the mean pulsatility index (PI). The correlations between mean PI with the pregnancy rate and the embryo implantation rate (number of embryos implanted/number of embryos transferred) were analyzed. Patients were grouped according to the mean PI value, and the pregnancy rate and embryo implantation rate were 25% (5/20) and 10.7% (9/84), respectively, with a PI < 2.0 (n = 20); 27.5% (14/51) and 12.2% (12/109), respectively, with a PI = 2.00-2.49 (n = 51); 9.5% (2/21) and 3.5% (2/57), respectively, with a PI = 2.50-2.99 (n = 21); and 6.3% (1/16) and 4.3% (2/47), respectively, with a PI [symbol: see text] 3.0 (n = 16). There were no significant differences in either pregnancy rate or embryo implantation rate between the groups with mean PI values less than 2.00 and between 2.00 and 2.49. If a mean PI value of 2.50 was used as the cut-off value, both the pregnancy rate and embryo implantation rate were significantly higher in patients with a mean PI less than 2.50 (p < 0.05). The uterine arterial impedance measured by the Doppler sonographic examination is a non-invasive method for evaluating the endometrial response and a mean uterine PI value of 2.5 can be used as a cut-off value to identify optimal uterine receptivity before embryo transfer.
在胚胎移植前，通过经阴道彩色多普勒超声检查研究子宫血流阻抗对胚胎着床率的影响。共有108名接受体外受精（IVF）程序且至少有一个优质胚胎可移植到子宫的女性在胚胎移植前接受了多普勒评估。通过对双侧子宫动脉进行血流波形分析的彩色血流成像来计算平均搏动指数（PI）。分析平均PI与妊娠率和胚胎着床率（着床胚胎数/移植胚胎数）之间的相关性。根据平均PI值对患者进行分组，PI<2.0（n=20）组的妊娠率和胚胎着床率分别为25%（5/20）和10.7%（9/84）；PI=2.00-2.49（n=51）组分别为27.5%（14/51）和12.2%（12/109）；PI=2.50-2.99（n=21）组分别为9.5%（2/21）和3.5%（2/57）；PI≥3.0（n=16）组分别为6.3%（1/16）和4.3%（2/47）。平均PI值小于2.00的组与2.00至2.49的组之间，妊娠率或胚胎着床率均无显著差异。如果将平均PI值2.50用作临界值，平均PI小于2.50的患者的妊娠率和胚胎着床率均显著更高（p<0.05）。通过多普勒超声检查测量的子宫动脉阻抗是评估子宫内膜反应的一种非侵入性方法，平均子宫PI值2.5可作为临界值，以在胚胎移植前识别最佳子宫接受性。
