The Effects Of Different Ovulation Induction Schemes On Endometrial Blood Flow, Thickness And Types

Endometrial blood flow, thickness, types are changed with the menstrualcycle.Medical ultrasound images have become the most important auxiliaryexamination means in monitoring follicles. During the different follicular type,medical ultrasound measures thickness, types, endometrial blood flow, thehemodynamic parameters (RI, PI and S/D value) of the endometrial spiralarteries, follicle size. The clinicians according to the results make the furthertreatment and evaluate the possibility of pregnancy for increasing thepregnancy rate. Most studies have shown that the thickness of the endometrium,endometrial hemodynamic parameters, endometrial type is closely related topregnancy.Object: To investigate the correlation between endometrial blood flow,thickness,types and pregnancy in patients of PCOS after using differentovulation drugs.Methods: A study involved119infertile women with PCOS (4groups) asobservation group, which were treated with different circles of differentovulation drugs:①Clomifene (CC)39cases,②Clomifene+EstradiolValerate (CC+PGV)23cases,③Clomifene+Menotrophin (CC+HMG)32cases,④letrozole (LE)25cases. There are145cycles of control study forovulation induction. When each group has1to3follicles diameter>18mm,Patients with subcutaneous injection of recombinant human chorionicgonadotropin75-150IU. Compare endometrial the blood flow parameters valuePI (pulsations index), RI (resistance index), S/D (systolic and diastolic speedratio), endometrial thickness, type, pregnancy rate among these groups in midand late follicular. Results:1. In middle and late follicles comparing with CC group and CC+PGV group, endometrial blood flow value in CC HMG group and LE groupwas significantly lower (P <0.05), while endometrial thickness wassignificantly greater. No significances were found between CC+HMG and LEgroup.2. Compared with CC group in mid follicles, endometrial blood flowvalue in CC+PGV group was lower,(P <0.05). Endometrial thickness betweentwo groups was not statistically significant.3. The pregnancy rate in CC+HMG group was significantly higher than other three groups (32.3%, P <0.05).4. In late follicles, compared with cases with no pregnancy, endometrial bloodflow value with pregnancy was lower (P <0.05) within a certain range（PI：0.79±0.1、RI：0.516±0.07、S/D：2.068±0.29）,and endometrial thickness in caseswith pregnancy was not statistically significant. Endometrial thickness within acertain range (8.92±1.5mm). Endometrial type had no difference among eachgroup(P>0.05), endometrial type A rate (70%) in cases with pregnancy washigher than the rate in cases with non-pregnancy (22%)(P <0.05).Conclusion:1. when treating infertile women with PCOS, CC+HMGand LE, endometrial thickness and endometrial blood perfusion was superiorto groups treating with CC and CC+PGV. pregnancy rates of CC+HMGgroup was the highest;2. when adding PGV to CC, the influence ofendometrial blood perfusion caused by CC could be improved;3. Endometrialblood flow parameters value PI, RI, S/D, thickness and types were correlatedwith pregnancy rates, which may be good means to evaluate endometrial let;4. Endometrial thickness of a single factor can not evaluate the outcome ofpregnancy. Endometrial thickness within a certain range (8.92±1.5mm),endometrium with a rich blood and endometrial morphology of the type A(three-line sign) is conducive to pregnancy before ovulation.