Study On Three-dimensional Sonography In Endometrial Receptivity Of Patients With Luteal Phase Defect Infertility

ObjectiveTo analyze endometrial volume and blood flows of the luteal phase defect infertility by three-dimensional ultrasound, measuring the acoustic image characteristics of this technology to assess the endometrial receptivity of the patients who suffering from luteal phase defect infertility, and provide imaging basis for clinical diagnosis and treatment.Methods1.Select20patients diagnosed as suffering from luteal phase defect infertility as observation group, while Selecting20childbearing age women who have the normal menstrual cycle and luteal function as the control group.2. In periovulatory phase and midluteal phase, we use transvaginal two-dimensional ultrasonic to measure endometrial thickness and PSV, RI, PI of uterine spiral artery blood flow in observation group and control group.3. We use three-dimensional ultrasonography and power doppler angiography and vinual organ computer-aided analysis software(VOCAL) to measure the endometrial volume, endometrial and subendometrial Vascularization index (VI), flow index(F1), vaseularization flow index(VFI).4. Comparisons of indices were made between the observation group and control group, and measure the correlation between the endometrial volume and the endometrial、subendometrial flow parameters, using ROC curve to evaluate the value of ultrasound indices in predicting luteal phase defect infertility.Results1.In two-dimensional ultrasound indices,endometrial thickness and PSV, RI, PI of uterine spiral artery have no statistical differences(P>0.05) between the two groups in periovulatory phase, in midluteal phase, RI of uterine spiral artery has statistical difference (P<0.05) between the two groups, the observation group’s RI is higher. However, the area under the ROC curve of RI is low(0.695), there is statistically significant (P<0.05).2. In three-dimensional ultrasound indices, endometrial volume, endometrial and subendometrial VI, FI, VFI have no statistical differences (P>0.05) between the two groups in periovulatory phase, in midluteal phase, endometrial volume, subendometrial FI, VFI have statistical differences (P<0.05) between the two groups, the observation group’s are lower. The area under the ROC curve of endometrial volume, subendometrial FI, VFI are0.810、0.680and0.723, the endometrial volume and subendometrial VFI’s ROC curve have statistical differences(P<0.05), subendometrial FI’s ROC curve has no statistical difference (P>0.05).3. In midluteal phase, all the subjects bounded in3ml values can be divided into two groups, there is statistically significant in endometrial and subendometrial VI, FI and VFI between the two groups (P<0.05), the parameters above in group of endometrial volume which≤3ml are lower than the group>3ml one.4. In midluteal phase, the endometrial volume≤3ml group has6patients, there are3cases can not be measured the spiral arteries;the endometrial volume>3ml group has34patients but just1case can not be measured the spiral arteries, there is statistically significant (P<0.05).Conclusions1.RI of uterine spiral artery has certain implications in reflecting the endometrial blood flow in luteal phase defect infertility, but the accuracy is not high.2. In luteal phase, endometrial volume, subendometrial FI, VFI are statistically lower than the contral group, which indicate that endometrial development and blood perfusion of the luteal phase defect infertility is not ideal in luteal phase, this is likely to be one of the causes of leading poor endometrial receptivity and embryo implantation failure in luteal phase defect infertility3.There is positive correlation between endometrial volume value and endometrial and subendometrial VI, FI, VFI measured by three-dimensional ultrasound in luteal phase defect infertility, we could use these two types of parameters to evaluate the endometrial receptivity luteal phase defect infertility. 4. Three-dimensional ultrasound is a sensitive means to evaluate endometrial receptivity of the patients who suffering from luteal phase defect infertility,it has a certain value to evaluate the endometrial receptivity of luteal phase defect infertility, its related parameters are better than two-dimensional ultrasound in evaluating whole blood flow of endometrium, the endometrial volume, subendometrial VFI are ideal evaluation parameters.