| Background:during this present period,the fertilization rate and the cleavage rate in in vitro fertilization and embryos transfer cycle (IVF-ET) can reach 80% and 90% separately,good embryo rate can reach 50%,while the embryo implantation rate of only 15%. What causes such a big gap between the both? One of the main reasons is the changes of endometrial receptivity. How to assess and improve the endometrial receptivity in patients is the bottleneck of increasing pregnancy rate.Objective:It is important to access the endometrial receptivity which success implantation depends on. Our study is to investigate the relationship between endometrial blood flow status measured by Color Doppler on pre-implantatiion and the endometrial receptivity.Methods:Data were obtained a total 134 women undergoing IVF-ET in Tianjin medical university general hospital reproductive center from March 2009 to November 2009. The endometrial thickness,blood flow status were detected by Philips iu-22 color Doppler ultrasonography,with transvaginal ultrasound probe frequency of 6.5MHz on the day of embryos transfer during IVF-ET cycles. Meanwhile 70 patients who accepted long protocol were detected the endometrial thickness,blood flow status on the third day after natural ovulation before IVF-ET cycles in addition. Measured the endometrial thickness,counted the number of blood flow perforating branches,and detected the blood flow in 2 to 3 points,obtained parameters:pulse index,resistance index,systolic/diastolic,time average peak velocity,peak systolic velocity,end diastolic velocity. All blood flow were achieved at least 3 to 5 cardiac cycles over.Results:(1) Cases of 134 IVF-ET stimulated cycles:The patients were divided into three groups by the show of endometrial blood flow:Ⅰ,the number of endometrial perforating blood flow≤2 branch;Ⅱ,the number of endometrial perforating blood flow 2-6 branch; III,the number of endometrial perforating blood flow≥6 branch. The pregnancy rate and implantation rate in gradeⅢ(40%,13.7%) were statistically higher than in gradeⅠ(10%,0%),gradeⅡ(29.41%, 9.3%),respectively(p<0.05). GradeⅠand gradeⅡ,Ⅲof endometrial blood flow were significantly different,separately(p<0.05). Grade II and III of endometrial blood flow showed no significant difference(p>0.05).The parameters RⅠ, PⅠ, S/D of pregnancy group were (0.57±0.08),(0.95±0.21),(2.44±0.46) respectively,significantly higher than non-pregnant group (0.52±0.08),(0.82±0.21),(2.14±0.42),(p<0.05).(2) Cases of 70 natural cycles and stimulated cycles both:There is significantly difference between pregnancy group and non-pregnancy group in natural cycle on the show of endometrial perforating blood flow that gradeⅠ,Ⅱ,Ⅲwere 0%,0%,100% and gradeⅠ,Ⅱ,Ⅲwere 2.78%,34.78%,60.87%, respectively (p<0.05). The parameters showed no difference between natural cycle and stimulated cycle.Conclusion:(1) Richer of endometrial perforating blood flow in stimulated cycle have higher pregnancy rate,which can be as forecast level of endometrial receptivity.(2) Higher of RI,PI,S/D values in stimulated cycle,may hint better endometrial receptivity.(3) Richer of endometrial perforating blood flow in natural cycle have higher pregnancy rate,basic endometrial blood status play an important role in embryo implantation.(4) Stimulated cycle may not change endometrial receptivity.(5) Combination of the status of the endometrial perforating blood flow and the blood flow parameters have guiding and predicting value to outcomes of IVF-ET. |
PDF Full Text Request