Application Of Transvaginal Color Doppler Ultrasound In In Vitro Fertilization-embryo Transfer(ivf-et)

PartⅠEvaluation of ovarian responsibility by TV-CDS and anti-mullerian hormone in in vitro fertilization-embryo transferObjective: To explore the application value of transvaginal color Doppler ultrasound (TV-CDS) and anti-mullerian hormone in predicting ovarian responsibility in in vitro fertilization- embryo transfer(IVF-ET).Methods: A total of 83 infertile women underwent IVF at 105th Hospital of PLA were investigated prospectively between March 2009 and November 2009,and all the women were divided into poor-response group (1～5 oocytes),normal-response group (6～15 oocytes) and high-response group ( over 15 oocytes) according to the number of retrieved oocytes. The serum baseline levels of anti-mullerian hormone(AMH)and follicle stimulating hormone(FSH)on the third day of menstrual cycle as well as serum AMH level on the day of hCG administration were measured by enzyme linked immunosorbent assay (ELISA)and chemoluminescence assay,respectively. Meanwhile,the ovarian volume,total number of antral follicles,pulsatility index(PI),resistance index(RI) ,peak systolic velocity/end diastolic velocity(S/D),peak systolic velocity (PSV ) and end diastolic velocity(EDV) of ovarian stromal vesselsarterial blood flow on the third day of menstruation prior to controlled super ovulariantion hyperstimulation and the day of hCG administration were measured by TV-CDS.All the detected blood flow parameters of the ovarian stromal vesselsartery and the number of oocytes,mature oocytes,fertilized eggs and good quality embryos in three groups were calculated and compared.Results: The ovarian volume was significantly higher in high-response group than that in normal and poor response groups. There were significantly differences in AFC,mature oocytes,fertilized eggs and good quality embryos among three groups. There were no significantly differences in PI,RI,S/D,PSV,EDV of the ovarian stromal vesselsarterial blood flow on the day of hCG administration among three groups,however,which showed significantly differences on the d3 of menstruation. The serum level of AMH was aslo found significantly increased in high-response group compared with normal and poor response groups.Conclusion: The ovarian volume,AFC,PI,RI,S/D,PSV,EDV of ovarian stromal blood flow and AMH have a great value in predicting ovary responsibility.PartⅡEvaluation of endometrial receptivity by TV-CDS in in vitro fertilization-embryo transferObjective: To explore the application value of transvaginal color Doppler ultrasound in predicting endometrial receptivity in in vitro fertilization- embryo transfe(rIVF-ET). Methods: A total of 148 infertile women underwent IVF at 105th Hospital of PLA were investigated prospectively between January 2009 and November 2009. The endometrial thickness and pattern of wave-like movements were observed,and pulsatility index(PI),resistance index(RI),peak systolic velocity/end diastolic velocity(S/D),peak systolic velocity (PSV) and end diastolic velocity (EDV) of uterine artery and uterine spiral arteries were measured by transvaginal color Doppler ultrasound (TV-CDS) on the day of hCG administration and the day of ET(embryo transfer). According to getting pregnancy or not,all patients were divided into pregnancy group and unpregnancy group.Results: The endometrial thickness on the day of ET in pregnancy group increased significantly compared with unpregnancy group,which showed no difference on the day of hCG administration between two groups. There were no differences in PI,RI,S/D,PSV,EDV of uterine artery as well as uterine spiral arteries between two groups. The frequency of negative endometrial wave-like movement on the day of hCG and ET in pregnancy group increased significantly compared with unpregnancy group.Conclusion: The endometrial thickness on the day of ET has more predictive value for endometrial receptivity than that on the day of hCG administration. The negative endometrial wave-like movements on the day of hCG administration and ET have an adverse effect on endometrial receptivity. TV-CDS could be serves as a useful tool for predicting endometrial receptivity in IVF-ET precedure.