子宫内膜形态、血流参数联合临床指标对多囊卵巢综合征患者辅助生殖妊娠结局的预测价值
Predictive Value of Endometrial Morphology,Blood Flow Parameters Combined with Clinical Indicators for Pregnancy Outcomes in Assisted Reproductive Patients with Polycystic Ovary Syndrome
陈淑金 1谢芳 2邱思花1
作者信息
- 1. 福建医科大学附属龙岩第一医院超声科 福建省龙岩市,364000
- 2. 福建医科大学附属龙岩第一医院生殖医学科 福建省龙岩市,364000
- 折叠
摘要
目的 探讨子宫内膜形态、血流参数联合临床指标对多囊卵巢综合征(PCOS)患者辅助生殖妊娠结局的预测价值.方法 回顾性分析行体外受精-胚胎移植(IVF-ET)的106例PCOS患者的临床资料.依据胚胎移植后28 d超声检查结果分为临床妊娠组、未妊娠组.比较两组临床资料,胚胎移植日应用经阴道超声测定子宫内膜形态、子宫内膜螺旋动脉血流指标[收缩期最大血流速度/舒张末期血流速度(S/D)、阻力指数(RI)、搏动指数(PI)]值.比较两组临床指标与子宫内膜形态、血流参数差异,分析PCOS患者IVF-ET后临床妊娠失败的影响因素,观察临床指标与子宫内膜形态、血流参数对PCOS患者IVF-ET后临床妊娠失败的预测价值.结果 Logistic回归分析显示,体重指数、子宫内膜形态C型、S/D、RI、PI为PCOS患者IVF-ET后临床妊娠失败的危险因素,既往妊娠史、取卵日抗苗勒管激素(AMH)水平为保护因素(P＜0.05).绘制ROC曲线显示,上述指标对临床妊娠失败均有一定预测价值,包含子宫内膜形态、血流参数的模型对PCOS患者IVF-ET后临床妊娠失败的预测价值更高(Z=4.876,P＜0.001).结论 子宫内膜形态、血流参数联合临床指标可提高对PCOS患者辅助生殖妊娠结局的预测效能,为临床个性化干预提供指导.
Abstract
Objective To investigate the predictive value of endometrial morphology,blood flow parameters combined with clinical indicators for pregnancy outcomes in assisted reproductive patients with polycystic ovary syn-drome(PCOS).Methods Clinical data of 106 PCOS patients who underwent in vitro fertilization-embryo transfer(IVF-ET)were retrospectively analyzed.Patients were divided into clinical pregnancy group and non-pregnancy group based on ultrasonography findings 28 days after embryo transfer.Clinical data were compared between the two groups.On embryo transfer day,transvaginal ultrasound was used to measure endometrial morphology and spiral ar-tery blood flow parameters[systolic/diastolic ratio(S/D),resistance index(RI),pulsatility index(PI)].Clinical in-dicators,endometrial morphology,and blood flow parameters were compared between groups.Risk factors for clinical pregnancy failure after IVF-ET in PCOS patients were analyzed,and the predictive value of clinical indicators com-bined with endometrial morphology and blood flow parameters was evaluated.Results Logistic regression analysis showed that body mass index,type C endometrial morphology,S/D,RI,and PI were risk factors for clinical pregnan-cy failure after IVF-ET in PCOS patients,while previous pregnancy history and anti-Müllerian hormone(AMH)lev-els on oocyte retrieval day were protective factors(P＜0.05).ROC curve analysis demonstrated that these indicators had certain predictive value for clinical pregnancy failure,with the model incorporating endometrial morphology and blood flow parameters showing higher predictive value for clinical pregnancy failure after IVF-ET in PCOS patients(Z=4.876,P＜0.001).Conclusions The combination of endometrial morphology,blood flow parameters,and clin-ical indicators can improve the predictive efficiency for pregnancy outcomes in PCOS patients undergoing assisted re-production,providing guidance for personalized clinical intervention.
关键词
子宫内膜形态/血流参数/多囊卵巢综合征/体外受精-胚胎移植/妊娠结局Key words
Endometrial morphology/Blood flow parameter/Polycystic ovary syndrome/In vitro fertilization-embryo transfer/Pregnancy outcome引用本文复制引用
出版年
2025
NETL
NSTL
万方数据