Research On The Relationship Between Blood Parameters Of Uterine Arterial And Subendometrial With The Outcomeof In Vitro Fertilization And Embryo Transfer

Objective To analyze the relationship among the indicators of uterine artery/spiral artery and outcome of embryo transfer for patients with In vitro fertilization/ Intracytoplasmic sperm injection and embryo transform(IVF/ICSI-ET) by Color Doppler, we tend to explore new protocols for those who suffer from repeated implantation failure in IVF/ICSI.Method 100 infertility patientsundergone IVF/ICSI-ET or FET were chosen for research. in the Center for Reproductive Medicine of General Hospital at Ningxia Medical University duringthe period of Aug.2015 ~ Dec.2015.48 samples with HCG≥25IU/ml were treated as research group,the rest 52 whose HCG < 25IU/ml as control group.According to protocol,all patients were re-divided into two groups:1 ET(n=47); 2 FET(n=53). A ultrasound examination with Doppler was performed on the implantation window phase to determine pulsatility index(PI) and resistance index(RI) of endometrial and subendometrial regions.The ELISA was used to measure the reproductive hormone levels. Statistical analysis was carried out using the SPSS18.0 software, with measurement data treated by t-test, enumeration data treated with x2-test.ROC curve and AUC was used to optimal cut-off value and judge monitoring value.Result(1) The endometrial thickness of the ET in the research group was significantly higher than the FET(12.86 ± 2.48 vs.10.81 ± 2.41, p<0.05).(2)The RI of uterine artery and spiral artery was much lower than the control group(0.69 ±0.09 vs.0.82±0.33;0.72±0.11 vs.0.77±0.15,all p<0.05),but the area under the ROC curve of RI was less than thereference area(p<0.01).(3)In the good qulity embryo transfer group,the RI of uterine artery and spiral artery in the research group was lower than the control group(0.68±0.09 vs.0.83±0.36;0.70±0.11 vs.0.78±0.16,all p<0.05).(4) ET basal LH of the experimental group was significantly higher than the control group(4.01±1.64 vs.2.70±1.27,p<0.05).Receiver Operator characteristic curve analysis revealed that the area under the curve was 0.75 for ET basal LH for pregnancy outcome(p<0.05).(5) The FET RI of uterine arteryin research groupwasmuch lower than the control group(0.69 ± 0.11 vs. 0.85 ± 0.41, P <0.05).(6) There was a trend ofmultiple pregnancies. in patients with lower RI(P> 0.05).Conclusion(1) The RI of uterine artery and spiral artery was a predictor of embryo transfer outcome.(2) There will be potential clinical application that improving blood perfusion of uterine artery and spiral artery help to improve the pregnancy rate for poor quality embryo transplanter.(3)The low RI of over two embryos transplantation will be more likely to multiple pregnancies.(4) E2/P is one of factors that affect endometrial blood flow but superphsiological E2.(5) Basal LH is one of the factors that influence ET outcome, when the underlying LH <2.58 m IU / ml, the embryo implantation rates dropped significantly..