The Effect Of Endometrial Blood Flow Distribution On Pregnancy Outcome In Patients With Thin Endometrium

Objective:At present,most people think that infertility patients with thin endometrium will have adverse pregnancy outcomes,and for patients with thin endometrium,there is no practical treatment to improve pregnancy outcomes.By comparing pregnancy outcomes between the infertility patients with rich endometrial blood flow and poor endometrial blood flow,explore if the endometrial blood flow contribution can provide suggestion with evidence on embryo transfer and predict the pregnancy outcome after transfer.Methods:Collect data from infertile patients who monitored endometrial blood flow distribution before transplantation during IVF/ICSI-ET treatment at the Reproductive Hospital of Shandong University from Nov.2015 to Dec.2019,establish inclusion and exclusion criteria to screen data,and organize the data,retrospectively investigate the endometrial thickness and endometrial blood flow distribution level obtained by transvaginal ultrasound examination before transplantation,the pregnancy outcomes after embryo transfer and other basic information of the patients.The endometrial blood flow distribution of the selected thin endometrium infertility patients is divided into grades Ⅰ,Ⅱ,and Ⅲ according to the judgment criteria,and those with under grade Ⅱblood flow are set as endometrial blood flow deficiency group,also called group 1.The patients with grade Ⅱ and above are set as endometrial blood flow rich group,also called group 2.Use statistical software SPSS23.0 to compare the basic information of the two groups,such as age,BMI,endometrial thickness,use the 1:1 PSM to make the baseline level consistent between the two groups,and then use chi-square test to compare whether the difference between the two groups’ pregnancy outcomes is statistically significant.Results:After sorting the collected data into a list,people who meet the criteria after being screened for inclusion and exclusion criteria are divided into two groups according to the type of endometrial blood flow distribution.SPSS 23.0 is used to match the baseline of the two groups of data.After match,there are 643 patients in each group.Compare three basic information(age,body mass index,endometrial thickness)of the two groups,there was no statistical difference.Data of age and BMI of the group are tested by normality,and they are not in accordance with the normal distribution.All of them are compared by the Mann-Whitney U test.The results of the above three tests are all P>0.05,and there is no statistical difference.Comparison of clinical pregnancy rate between the two groups included,the rich endometrial blood flow group have a higher clinical pregnancy rate than the poor endometrial blood flow group,but there is no statistical difference between the two groups.Conclusion:After the above data analysis,it can be concluded that the endometrial blood flow distribution has no effect on the clinical pregnancy rate after IVF/ICSI-ET treatment in women with thin endometrial infertility.There is no statistical difference in clinical pregnancy rate between women whose endometrial blood flow are abundant(B-ultrasound monitoring endometrial blood is grade II and above)and women with thin endometrial infertility and with lack of endometrial blood flow(endometrial blood flow in B-ultrasound monitoring is below grade II),that is,the two groups have the same probability of obtaining clinical pregnancy.Therefore,when the endometrial thickness monitored before transplantation in infertile patients is less than 8mm,it is not necessary to consider the endometrial blood flow status in this cycle of transplantation.