The Study On The Endometrium Receptivity Of The Patients With Infertility Examined By Three-dimensional Power Doppler Ultrasound

Objective: Through investigating the endometrial thickness,morphology,volume,endometrial and the volume parameters from sub-endometrial blood flow,spiral artery and the flow parameters of uterine artery blood by intrauterine three-dimensional ultrasound,we want to explore the relationship between endometrial tissue VEGF protein and VEGF m RNA,and to find the indicators to the receptivity of endometrium from ultrasonic evaluation.Methods:Among the 560 patients during line IVF-ET assisted reproduction treatment from June 216 to September 2017 in the reproductive medicine center of the first affiliated hospital of Soochow University,50 patients with fresh embryo transfer cycles and endometrial specimens and 238 patients with frozen embryo transfer cycle were selected in the study.Western Blotting and RT-PCR were used to detect endometrial VEGF protein and VEGF m RNA expression levels in patients with fresh embryo transplantation.Lumen three-dimensional power doppler ultrasound detecting fresh embryo transfer cycles and frozen embryo transfer cycles in patients with endometrial thickness,type,volume,endometrium and endometrial blood flow volume parameters,spiral artery and uterine artery blood flow parameters.All data are entered into the computer using SPSS23.0 software for statistics.Results :(1)In 238 cases of frozen embryo transfer,98 cases were pregnant,and the pregnancy rate was 41.2%.There was no significant difference in the thickness of endometrium and subtype,endometrial volume,and uterine artery flow parameters between pregnancy and non-pregnancy groups(P > 0.05).There was a statistically significant difference between the two groups between the endometrium and the endometrium(P=0.027).Set of endometrium and pregnancy lining under 3D-PDA parameter(VI,FI and VFI)were higher than in non pregnancy group,the comparison between the two groups was statistically significant(P < 0.05),VI,FI and VFI in the area under the ROC curve is 0.857,0.728,0.810,respectively;Pregnancy group of uterine spiral artery blood flow parameters(RI,PI)were significantly lower than the pregnancy group,comparing differences between the two groups were statistically significant(P = 0.010,P = 0.027),RI,PI,the area under the ROC curve were 0.607,0.601,respectively.(2)In 50 cases of fresh embryo transfer cycle,clinical pregnancy group(25 cases)and not the endometrial thickness of pregnancy group(25 cases),lining type,uterine artery blood flow parameters had no statistical significance(P > 0.05);Set of endometrium and pregnancy lining under 3 d PDA parameter(VI,FI and VFI)were higher than in non pregnancy group,the comparison between the two groups was statistically significant(P < 0.001,P = 0.008,P = 0.002),VI,FI and VFI in the area under the ROC curve were 0.949,0.792,0.717,respectively.Pregnancy group of uterine spiral artery blood flow parameters(RI,PI)were significantly lower than the pregnancy group,comparing differences between the two groups were statistically significant(P = 0.001,P < 0.001),RI,PI,the area under the ROC curve were 0.828,0.826,respectively.(3)There was a high positive correlation between the expression of VEGF m RNA in the endometrium of the embryo implantation window and the intimal vascular index VI(r=0.741,P < 0.01).There was a moderate positive correlation with endometrial blood index FI(r=0.561,P < 0.01).There was a moderate positive correlation with endovascular blood flow index VFI(r=0.429,P=0.02).Conclusion:The relative ultrasonic parameters from monitoring the endometrium by Intrauterine three-dimensional power doppler ultrasound can reflect the endometrial perfusion,assess endometrial receptive,and predict IVF-ET pregnancy outcomes.They will have the obvious clinical value to guide the Infertility patients to choose optimal time for embryo user and the instruction conception,in order to obtain the best treatment outcome.