Clinical value of three-dimensional power Doppler ultrasound in predicting pregnancy outcomes in adenomyosis patients after in vitro fertilization-embryo transfer
Objective To explore the clinical application value of transvaginal three-dimensional power Doppler ultrasound(3D-PDUS)in predicting pregnancy outcomes in adenomyosis patients after in vitro fertilization-embryo transfer(IVF-ET).Methods A total of 100 adenomyosis patients with infertility(study group)and 40 patients with single infertility(control group)who underwent IVF-ET in our hospital were enrolled.All patients underwent transvaginal 3D-PDUS examination before IVF-ET to observe the morphology of the endometrial-myometrial interface(EMI),and the average thickness,volume,vascularization index(VI),flow index(FI)and vascularization flow index(VFI)of the EMI were obtained.The differences of the above parameters between the two groups were compared.The pregnancy outcomes in study group were recorded.The differences in the morphology of the EMI,the average thickness,volume,VI,FI,VFI of the EMI between pregnancy and non-pregnancy patients were compared.The independent influencing factors of pregnancy outcomes in adenomyosis patients were screened by binary Logistic regression analysis.The diagnostic efficiency of transvaginal 3D-PDUS for predicting pregnancy outcomes after IVF-ET was analyzed by receiver operating characteristic(ROC)curves.Results The proportion of normal EMI morphology and FI in study group were lower than those in control group(both P＜0.05).There were no significant difference in average thickness,volume,VI and VFI of EMI between the two groups.In the study group,there were 60 cases with successful pregnancy and 40 cases without pregnancy.Proportion of normal EMI morphology,average thickness,volume,VI,FI and VFI of EMI in pregnancy patients were higher than those in non-pregnancy patients(all P＜0.05).Binary Logistic regression analysis showed that the volume and VFI of EMI were independent influencing factors of pregnancy outcomes in adenomyosis patients after IVF-ET(OR=4.725,2.160,both P＜0.05).ROC curve analysis showed that the area under the curve(AUC)and cut-off value of the volume and VFI of EMI for predicting pregnancy outcomes were 0.795,0.672 and 3.085 cm3,0.597,respectively.Conclusion Transvaginal 3D-PDUS can better predict pregnancy outcomes in adenomyosis patients after IVF-ET,which has certain clinical value.
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