Value of endometrial echo pattern transformation after hCG trigger in predicting IVF pregnancy outcome: a prospective cohort study
Value of endometrial echo pattern transformation after hCG trigger in predicting IVF pregnancy outcome: a prospective cohort study
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hCG 触发后子宫内膜回声模式转变在预测 IVF 妊娠结局中的价值：一项前瞻性队列研究
DOI：
10.1186/s12958-019-0516-5
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发表时间：
2019-09-05
影响因子：
4.4
通讯作者：
Li, Yanping
中科院分区：
文献类型：
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作者：
Hou, Zhaojuan;Zhang, Qiong;Li, Yanping
研究背景：无创性子宫内膜容受性测量方法的确定具有重要价值，因为它有可能改善体外受精（IVF）后的结局。有人认为，hCG给药当天的子宫内膜回声是子宫内膜容受性的良好标志。在日常实践中，我们注意到胚胎移植当天子宫内膜不均匀高回声的患者通常妊娠率较低。因此，我们扩展了hCG触发后子宫内膜回声模式转变的研究，以分析子宫内膜回声转变与IVF结局之间的关系。方法2017年8月至2018年8月，共招募了146名接受第一个IVF周期的不孕妇女，进行前瞻性队列研究。在hCG触发后对这些患者进行一系列子宫内膜回声模式监测：hCG日，取卵后1 - 3天（OPU + 1，OPU + 2，OPU + 3）。结果子宫内膜回声值计算为高回声子宫内膜面积占子宫内膜总面积的比值。临床妊娠率和胚胎种植率与回声值呈正相关。子宫内膜回声的ROC曲线分析显示取卵后第2天子宫内膜回声的曲线下面积最大（OPU + 1、2、3分别为0.738、0.765、0.714）。OPU + 2的子宫内膜回声值具有较高的预测效率，截断值为76.5%。敏感性为61.3%，特异性为82.0%。当将截止值设置为
Background There is much value in identifying non-invasive ways of measuring endometrial receptivity, as it has the potential to improve outcomes following in vitro fertilization (IVF). It has been suggested that endometrial echogenicity on the day of hCG administration was a good marker of endometrial receptivity. In the daily practice, we notice that patients with non-homogeneous hyperechoic endometrium on the embryo transfer day usually have lower pregnancy rates. We therefore extended the research onward transformation of echo pattern after hCG trigger to analyze the relationship between endometrial echogenicity transformation and IVF outcomes. Methods A total of 146 infertile women undergoing their first IVF cycle were recruited in the prospective cohort study from August 2017 through August 2018. A series of endometrial echo pattern monitoring was carried out in these patients after hCG trigger: hCG day, from 1 through 3 days after ovum pick-up (OPU + 1, OPU + 2, OPU + 3). Results The endometrial echogenicity value was calculated as the ratio of the hyperechogenic endometrial area over the whole endometrial area. Clinical pregnancy rate and embryo implantation rate had positive relationship with echogenicity value. The ROC curve analysis of endometrial echogenicity showed the area under curve was greatest on the second day after oocyte retrieval (OPU + 1, 2, 3 were 0.738, 0.765, 0.714 respectively) versus pregnancy. Endometrial echogenicity value on OPU + 2 had a higher predictive efficiency, and the cutoff value was 76.5%. The sensitivity was 61.3% and specificity was 82.0%. When putting the cut-off at