三维超声参数对IVF/ICSI-ET妊娠结局的预测价值

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目的:探讨三维超声参数对体外受精/卵胞质内单精子显微注射-胚胎移植(IVF/ICSIET)妊娠结局的预测价值。方法:回顾性分析697例行IVF/ICSI助孕患者h CG注射日子宫内膜及内膜下超声参数,根据临床妊娠与否分组,比较妊娠组与非妊娠组的资料,并进一步根据促排卵方案行分层分析,研究各项超声参数与妊娠结局的关联。结果:1妊娠组的年龄、不孕年限和IVF周期数显著低于非妊娠组(P<0.05),而妊娠组的子宫内膜厚度、内膜体积大于非妊娠组(P<0.05),妊娠组螺旋动脉收缩期速度(PSV)和舒张末期速度(EDV)、内膜下1 mm血流指数(FI)、内膜下3 mm的FI和血管血流指数(VFI)高于非妊娠组,差异均有统计学意义(P<0.05)。2超声参数与长方案患者妊娠结局无明显关联,而在短方案促排卵患者中,妊娠组和非妊娠组的内膜厚度及螺旋动脉EDV存在统计学差异(P<0.05)。3Logistic回归显示周期数和内膜厚度可作为短方案患者妊娠结局的预测指标,受试者工作特征(ROC)曲线分析也提示内膜厚度对妊娠具有一定的预测价值。结论:IVF/ICSI患者h CG注射日子宫内膜和内膜下三维超声参数对妊娠结局的预测价值十分有限,内膜厚度对短方案患者妊娠具有一定的预测作用。 Objective: To investigate the predictive value of three-dimensional ultrasound parameters in pregnancy outcome of in vitro fertilization / intracytoplasmic sperm injection-embryo transfer (IVF / ICSIET). Methods: The endometrial and subendothelial ultrasound parameters of 697 patients undergoing IVF / ICSI were retrospectively analyzed. According to the clinical pregnancy or not, the data of pregnant and non-pregnant women were compared and further evaluated according to ovulation induction Hierarchical analysis of programs to study the correlation between ultrasound parameters and pregnancy outcomes. Results: The age, duration of infertility and the number of IVF cycles in 1 pregnancy group were significantly lower than those in non-pregnancy group (P <0.05), while the pregnancy group’s endometrial thickness and intima volume were greater than those in non-pregnancy group (P <0.05) The rates of PSV and EDV, FI in subendocardium, FI in 3 mm in subendocardium and VFI in subendocardium were higher than those in non-pregnant group, The differences were statistically significant (P <0.05). There was no significant correlation between ultrasound parameters and pregnancy outcome in patients with long-term regimen. In short-term ovulation induction patients, there were significant differences in intima-media thickness and spiral arterial EDV between pregnant women and non-pregnant women (P <0.05). 3Logistic regression analysis showed that the number of cycles and intima-media thickness could be used as predictors of pregnancy outcome in short-term patients. ROC curve also suggested that intima thickness had a certain predictive value in pregnancy. CONCLUSION: The predictive value of endometrial and subendinal three-dimensional ultrasound parameters at h CG injection on IVF / ICSI patients for pregnancy outcome is very limited. Intimal thickness may have some predictive value for pregnancy in short-term patients.
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