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目的探讨经阴道彩色多普勒超声(color doppler ultrasound,CDU)在评价自然周期供精人工授精(artificial insemination by donor,AID)结局中的价值。方法选择2011年9月至2014年3月广东省计划生育专科医院生殖中心采用CDU检查的608例行自然周期AID患者资料,按临床妊娠与否分为妊娠组(159例)和未妊娠组(449例),比较两组患者子宫内膜厚度、分型、子宫动脉血流参数、子宫内膜及内膜下血流等指标,分析不同指标与AID临床妊娠率的关系。结果两组患者的子宫内膜厚度、子宫动脉阻力指数和搏动指数比较差异均无统计学意义(P>0.05);内膜分型A型者妊娠率30.13%(91/302),高于B型者23.33%(63/210)、C型者13.89%(5/36),(P<0.05);子宫内膜及内膜下有血流者妊娠率31.58%(102/323),高于内膜及内膜下均无血流者2.44%(1/41),(P<0.05)。同一种内膜分型下,不同血流的临床妊娠率比较差异均有统计学意义(P<0.05)。结论经阴道CDU监测子宫内膜类型及子宫内膜及内膜下血流对评估子宫内膜容受性、预测临床结局有重要意义,对内膜及内膜下血流的预测价值更高。
Objective To investigate the value of transvaginal color doppler ultrasound (CDU) in assessing the outcome of artificial insemination by donor (AID). Methods From September 2011 to March 2014, the data of 608 patients with natural period AID who underwent CDU examination in the Reproductive Center of the Family Planning Specialized Hospital of Guangdong Province were divided into pregnancy group (159 cases) and non-pregnancy group 449 cases). The endometrial thickness, typing, uterine artery blood flow parameters, endometrial and subintimal blood flow were compared between the two groups. The relationship between different indexes and clinical pregnancy rate was analyzed. Results There was no significant difference in endometrial thickness, uterine artery resistance index and pulsatility index between the two groups (P> 0.05). The pregnancy rate of type A endometriosis was 30.13% (91/302), higher than that of B 23.33% (63/210) of type and 13.89% (5/36) of type C, respectively (P <0.05). Pregnancy rate was 31.58% (102/323) in endometrial and subintimal blood vessels, Intima and intima were no blood flow were 2.44% (1/41), (P <0.05). The same type of endometriosis, the clinical pregnancy rate of different blood flow differences were statistically significant (P <0.05). Conclusions Transvaginal CDU monitoring of endometrial types and endometrial and subintimal blood flow is important for assessing endometrial receptivity and predicting clinical outcomes, with higher predictive value for endometrial and subintimal blood flow.