PDF(Pubmed)
Abstract：
Ultrasound has become a routine method for endometrial receptivity (ER) evaluation. However, there is controversy over the independent evaluation values of various ultrasound indicators. Some researchers have designed multi-indicator prediction systems, but their prediction values are uneven. To further our understanding of ER, we conducted this prospective cohort study to estimate ER noninvasively and effectively.
Women who underwent the first frozen-thawed embryo transfer (FET) cycle from April 2019 to July 2021 were included in the study. On the day of transfer, transvaginal three-dimensional ultrasound examination was performed to evaluate ER, including endometrial thickness, morphology, volume, movement, blood flow and flow index. The clinical pregnancy rate was the primary outcome. Based on whether clinical pregnancy was achieved, enrolled patients were divided into pregnant and nonpregnant groups.
This study analyzed 197 FET patients (139 pregnancies in total, 70.5%). The protective factors for clinical pregnancy included primary infertility [adjusted odds ratio (aOR), 1.98; 95% confidence interval (CI), 1.01-3.882; p = 0.047] and more frequent endometrial peristalsis (aOR, 1.33; 95% CI, 1.028-1.722; p = 0.03). Scores of 1-2 were assigned according to the relationship between different ultrasound indicators and the clinical pregnancy rate (CPR). The ER score of the patient was the sum of the scores of the 6 items. The ER score of the pregnant group was significantly higher than that of the nonpregnant group (7.40 ± 1.73 vs. 6.33 ± 1.99, p = 0.001). The CPR increased with an increasing ER score. The CPR in the ER < 6 group was significantly lower than that in the ER >6 group (45.5% vs. 75.6%, p = 0.001).
A noninvasive ultrasound scoring system for ER was proposed. This system may provide a non-invasive guidance perspective, in conjunction with invasive assessments currently used in clinical practice, to achieve more effective embryo transfer.
Women who underwent the first frozen-thawed embryo transfer (FET) cycle from April 2019 to July 2021 were included in the study. On the day of transfer, transvaginal three-dimensional ultrasound examination was performed to evaluate ER, including endometrial thickness, morphology, volume, movement, blood flow and flow index. The clinical pregnancy rate was the primary outcome. Based on whether clinical pregnancy was achieved, enrolled patients were divided into pregnant and nonpregnant groups.
This study analyzed 197 FET patients (139 pregnancies in total, 70.5%). The protective factors for clinical pregnancy included primary infertility [adjusted odds ratio (aOR), 1.98; 95% confidence interval (CI), 1.01-3.882; p = 0.047] and more frequent endometrial peristalsis (aOR, 1.33; 95% CI, 1.028-1.722; p = 0.03). Scores of 1-2 were assigned according to the relationship between different ultrasound indicators and the clinical pregnancy rate (CPR). The ER score of the patient was the sum of the scores of the 6 items. The ER score of the pregnant group was significantly higher than that of the nonpregnant group (7.40 ± 1.73 vs. 6.33 ± 1.99, p = 0.001). The CPR increased with an increasing ER score. The CPR in the ER < 6 group was significantly lower than that in the ER >6 group (45.5% vs. 75.6%, p = 0.001).
A noninvasive ultrasound scoring system for ER was proposed. This system may provide a non-invasive guidance perspective, in conjunction with invasive assessments currently used in clinical practice, to achieve more effective embryo transfer.
摘要：
■超声已成为评估子宫内膜容受性（ER）的常规方法。然而,各种超声指标的独立评估值存在争议。一些研究人员设计了多指标预测系统，但是它们的预测值是不均匀的。为了进一步了解ER，我们进行了这项前瞻性队列研究,目的是无创且有效地估计ER.
■从2019年4月至2021年7月接受第一个冻融胚胎移植（FET）周期的女性被纳入研究。转移当天,经阴道三维超声检查评价ER,包括子宫内膜厚度，形态学,volume,运动,血流和血流指数。临床妊娠率是主要结局。根据是否达到临床妊娠，纳入的患者分为妊娠组和非妊娠组.
■这项研究分析了197例FET患者（总共139例怀孕，70.5%）。临床妊娠的保护因素包括原发性不孕症[调整比值比（aOR），1.98；95%置信区间(CI)，1.01-3.882；p=0.047]和更频繁的子宫内膜蠕动（aOR，1.33；95%CI，1.028-1.722；p=0.03）。根据不同超声指标与临床妊娠率(CPR)的关系,分为1～2分。患者的ER评分为6项评分的总和。妊娠组的ER评分明显高于非妊娠组(7.40±1.73vs.6.33±1.99，p=0.001）。CPR随着ER评分的增加而增加。ER<6组的CPR明显低于ER>6组（45.5%vs.75.6%,p=0.001)。
■提出了一种用于ER的无创超声评分系统。该系统可以提供非侵入性的引导视角，结合目前在临床实践中使用的侵入性评估，实现更有效的胚胎移植。
■从2019年4月至2021年7月接受第一个冻融胚胎移植（FET）周期的女性被纳入研究。转移当天,经阴道三维超声检查评价ER,包括子宫内膜厚度，形态学,volume,运动,血流和血流指数。临床妊娠率是主要结局。根据是否达到临床妊娠，纳入的患者分为妊娠组和非妊娠组.
■这项研究分析了197例FET患者（总共139例怀孕，70.5%）。临床妊娠的保护因素包括原发性不孕症[调整比值比（aOR），1.98；95%置信区间(CI)，1.01-3.882；p=0.047]和更频繁的子宫内膜蠕动（aOR，1.33；95%CI，1.028-1.722；p=0.03）。根据不同超声指标与临床妊娠率(CPR)的关系,分为1～2分。患者的ER评分为6项评分的总和。妊娠组的ER评分明显高于非妊娠组(7.40±1.73vs.6.33±1.99，p=0.001）。CPR随着ER评分的增加而增加。ER<6组的CPR明显低于ER>6组（45.5%vs.75.6%,p=0.001)。
■提出了一种用于ER的无创超声评分系统。该系统可以提供非侵入性的引导视角，结合目前在临床实践中使用的侵入性评估，实现更有效的胚胎移植。
