| Objective To investigate the variation of uterine artery RI and PI in the natural cyclesand controlled ovarian hyperstimulation cycles, and the relationship of pregnancy outcomebetween endometrial thickness,morphology and uterine artery RI and PI in IVF-ET in order toexplore a new invasive predict to assessment of endometrial receptivity.Methods120cases of infertile women undergoing IVF treatment because of tubalfactor had their first IVF cycles at Reproductive Medicine Center of the Genaral Hospital ofNingxia Medical University.To monitor endometrial thickness, mophology, and bilateraluterine artery RI and PI on the early follicular phase, ovulation and the mid-luteal phase in thenatural menstrual cycles and on the Gn, hCG, OPU, ET day in COH cycles andchemiluminescence determination of the serum estradiol and progesterone.Pairedt-test,Chi-Square Test, One-way ANOVA and Pearson correlate were used in analysis of data.Results （1）uterine artery RI and PI in the left and right were significant difference(F=41.428、F=41.740、F=85.797、F=83.371，p<0.05) on the early follicular phase, ovulationand the mid-luteal phase in the natural menstrual cycles;(2) uterine artery PI/RI in the leftand right ratio existed significant difference during the early follicular phase, ovulation andthe mid-luteal phase (F=101.095, F=101.47, p <0.05);(3) uterine artery RI in the ovulationand the mid-luteal phase correlated negatively with serum E2(r=-0.390, r=-0.508, p<0.05), P(r=-0.124, r=-0.198, p <0.05), uterine artery PI in the ovulation and themid-luteal phase with serum E2(r=-0.236, r=-0.468, p <0.05), with serum P in themid-luteal phase (r=-0.468, p <0.05) was significantly negatively correlated.;(4)endometrial thickness was significantly negatively correlated uterine artery RI and PI (r=-0.213、r=-0.443、r=-0.251、r=-0.243、r=-0.248、r=-0.206，p all＜0.05);(5) Before andafter GnRH-a downregulation, the bilateral uterine artery RI and PI were significantdifference (0.83±0.03vs.0.81±0.04,3.71±0.50vs.2.19±0.32,0.82±0.03vs.0.80±0.04,3.67±0.47vs.2.10±0.30, p all<0.05);(6)The uterine artery RI and PI on ET day ofthe pregnancy group were statistically significant differences lower than the non-pregnantgroup (0.78±0.032vs.0.81±0.031,1.86±0.16vs.1.96±0.190， p all＜0.05);(7)Endometrialthickness in the pregnancy group of ET day were higher than the non-pregnant group（11.68±1.62vs.10.52±1.74，p all＜0.05）;(8) On Gn day In COH cycle, the endometrialthickness of5-6mm,which clinical pregnancy rate was significantly higher than3-4mm and7-8mm （72.91%vs.43.73%vs.54.05%，2＝7.729，p﹤0.05）.Conclusions (1) Uterine artery RI and PI of the menstrual cycle reduced regularly withthe changes of the ovarian cycle，and were significantly negatively correlated with the E2andP levels in the ovulation and mid-luteal serum, indicating that complement estrogen andprogesterone may affect uterine blood supply.(2) Uterine artery RI and PI were significantlynegatively correlated with the thickness of the endometrium, so changes in the uterine arteryRI and PI can increase endometrial thickness.(3) In ET day，uterine artery RI and PI ofpregnancy group were significantly lower than that of non-pregnant group, suggesting that ETmonitoring of uterine artery RI and PI can predict endometrial receptivity.(4) The clinicalpregnancy rate was highest when endometrial thickness is at13-15mm on ET day，showingthat monitoring of endometrial thickness on the day of hCG is the best time to takeintervention measures to improve the status of endometrium.(5) Monitoring of uterine arteryRI and PI by color Doppler ultrasound, combining with endometrial thickness andmorphology is a more comprehensive and objective hemodynamic index of evaluatingendometrial receptivity. |
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