Ultrasound Parameters Analysis Of Embryo Transfer Pregnancy In Thin Endometrium

Objective: The endometrial ultrasound parameters of patients with thin endometrium on the day of in vitro fertilization and embryo transfer(IVF-ET)were detected by ultrasound,and the differences in pregnancy outcomes between fresh embryo transfer and frozen embryo transfer were analyzed.The ultrasound parameters and pregnancy outcomes between clinical pregnancy group and non-pregnancy group were compared and analyzed to explore the clinical guiding value and significance of ultrasound parameters in patients with thin endometrium.Methods: According to the inclusion criteria and exclusion criteria,174 patients with thin endometrium(≤8mm)on the day of transplantation were selected from patients with in vitro fertilization and embryo transfer(IVF-ET)in our reproductive center from January 2021 to May 2022.According to the type of embryo transfer,the samples were divided into ET group(fresh embryo transfer)and FET group(frozen-thawed embryo transfer),and further divided into three subgroups : 7mm<EMT≤8mm subgroup(118 cases),6mm<EMT≤7mm subgroup(46 cases),EMT≤6mm subgroup(10 cases).The differences between fresh embryo transfer and frozen-thawed embryo transfer and pregnancy outcomes were compared in the three subgroups.Endometrial thickness,morphology,endometrial peristalsis mode and frequency,endometrial and subendometrial blood flow distribution,uterine spiral artery and uterine artery blood flow PSV,EDV,PI,RI and S / D were measured and recorded at 8: 00-9: 00 on the day of transplantation.Serum β-HCG of all patients was detected 14 days after transplantation and the results were recorded.Transvaginal ultrasonography was performed on the positive patients 30 days after transplantation,and the pregnancy outcome was recorded.The patients with positive serum β-HCG and ultrasound diagnosis of intrauterine pregnancy(80 cases)were determined as the clinical pregnancy group,and the patients with negative serum β-HCG,biochemical pregnancy and ectopic pregnancy(94 cases)were determined as the non-pregnancy group.Results:1.In 73 cases of fresh embryo transfer group,31 cases(42.47%)were clinical pregnancy,42 cases(57.53%)were non-pregnancy,101 cases of frozen-thawed embryo transfer,49 cases(48.51%)were clinical pregnancy,52 cases(51.49%)were non-pregnancy,the difference between the groups was not statistically significant(P >0.05),but the frozen-thawed embryo transfer program obtained a higher clinical pregnancy rate than the fresh embryo transfer program group.2.There was no significant difference in endometrial thickness,morphology,endometrial peristaltic wave mode and frequency,uterine spiral artery and uterine artery PSV,EDV and S / D between the two groups(P>0.05),but there were significant differences in endometrial and subendometrial blood flow distribution,uterine spiral artery PI,RI and uterine artery PI,RI between the two groups(P<0.05).3.There was no significant difference in clinical pregnancy rate and non-pregnancy rate among the three subgroups : 7mm<EMT≤8mm subgroup,6mm<EMT≤7mm subgroup and EMT≤6mm subgroup(P>0.05),but the clinical pregnancy rate of 7mm<EMT ≤ 8mm subgroup was significantly higher than that of the other two subgroups,and the non-pregnancy rate increased with the decrease of endometrial thickness.4.In this study,the thinnest endometrial thickness of successful pregnancy in fresh embryo transfer group was 6.5mm,and the thinnest endometrial thickness of successful pregnancy in frozen-thawed embryo transfer group was 5.0mm.Conclusion: The uterine spiral artery and uterine artery in patients with thin endometrium have an effect on the pregnancy outcome of embryo transfer.The PI and RI of uterine spiral artery and PI and RI of uterine artery in the clinical pregnancy group of thin endometrium are lower than those in the non-pregnancy group.In patients with thin endometrium,the pregnancy rate decreased with the decrease of endometrial thickness on the day of transplantation,but there was no significant difference in clinical pregnancy rate between frozen-thawed embryo transfer and fresh embryo transfer.