CAJ | 학술논문

目的：分析种植窗期子宫内膜厚度、类型和宫腔冲洗液中白血病抑制因子（ LIF）水平与体外受精胚胎移植（ IVF-ET）妊娠结局的关系。方法选择行IVF或ICSI治疗的不孕患者105例，于IVF-ET前1个月经周期排卵后第7～9天，行阴道超声测量子宫内膜的厚度并分型，ELISA法测定宫腔冲洗液中的LIF。结果105例不孕症患者IVF-ET治疗后，妊娠64例、未妊娠41例，二者年龄、不孕时间、不孕类型差异无统计学意义；妊娠者种植窗期子宫内膜厚度为（11．89±1．63）mm，小于未妊娠者的（13．72±2．39）mm，P＜0．05；子宫内膜厚度7～10、10～13、13～17 mm时，IVF-ET妊娠率分别为40．0％、72．7％、41．4％。本组A、B、C三种类型子宫内膜分别为50、36、19例，其妊娠率分别为70．0％、63．9％、31．6％；其中A型与B、C型比较，P均＜0．05；B、C型比较，P＞0．05。妊娠者宫腔冲洗液中LIF为（41．19±31．02）pg/mL，高于未妊娠者的（23．43±23．09）pg/mL，P＜0．05。结论 IVF-ET前1个月经周期中经阴道超声测定子宫内膜的厚度和类型、检测宫腔冲洗液中LIF浓度对评价子宫内膜容受性、预测临床妊娠结局具有重要意义。
목적：분석충식창기자궁내막후도、류형화궁강충세액중백혈병억제인자（ LIF）수평여체외수정배태이식（ IVF-ET）임신결국적관계。방법선택행IVF혹ICSI치료적불잉환자105례，우IVF-ET전1개월경주기배란후제7～9천，행음도초성측양자궁내막적후도병분형，ELISA법측정궁강충세액중적LIF。결과105례불잉증환자IVF-ET치료후，임신64례、미임신41례，이자년령、불잉시간、불잉류형차이무통계학의의；임신자충식창기자궁내막후도위（11．89±1．63）mm，소우미임신자적（13．72±2．39）mm，P＜0．05；자궁내막후도7～10、10～13、13～17 mm시，IVF-ET임신솔분별위40．0％、72．7％、41．4％。본조A、B、C삼충류형자궁내막분별위50、36、19례，기임신솔분별위70．0％、63．9％、31．6％；기중A형여B、C형비교，P균＜0．05；B、C형비교，P＞0．05。임신자궁강충세액중LIF위（41．19±31．02）pg/mL，고우미임신자적（23．43±23．09）pg/mL，P＜0．05。결론 IVF-ET전1개월경주기중경음도초성측정자궁내막적후도화류형、검측궁강충세액중LIF농도대평개자궁내막용수성、예측림상임신결국구유중요의의。
Objective To explore the possible relationships of thickness and types of endometria in the window of im -plantation and leukemia inhibitory factor ( LIF) in uterine flushing fluid with the outcome of in vitro fertilization and embryo transfer ( IVF-ET) .Methods A total of 105 patients with infertility who underwent in vitro fertilization ( IVF) or intracy-toplasmic sperm injection ( ICSI) were examined in the window of implantation (7-9days after ovulation ) before the previ-ous cycle of IVF-ET.The thickness and sonographic appearance of endometrium was measured by transvaginal ultrasonogra -phy, and the concentrations of LIF in uterine flushing fluid by enzyme linked immunosorbent assay (ELISA).Results Sixty-four patients were successful in pregnancy and 41 patients failed after treatment .There was no difference in age , in-fertility time and infertility type between pregnant women and non-pregnant women .The endometrial thickness in the win-dow of implantation of pregnant women was significantly less than that of non -pregnant ones [(11.89 ±1.63) mm vs (13.72 ±2.39) mm](P<0.05).The endometrial thickness was divided into three groups:7-10mm, 10-13mm and 13-17mm, and the corresponding pregnant rates were 40%, 72.73%and 41.38%.The endometrial type of 50 women was A, of 36 women was B and of 19 women was C, and the corresponding pregnant rates were 70%, 63.9%and 31.6%.There was significant difference in the pregnant rate between type A and B , between type A and C (all P<0.05), but there was no significant difference between type B and C (P>0.025).The concentration of LIF in uterine flushing fluid of pregnancy group was higher than non-pregnancy group [(41.19 ±31.02) pg/mL vs (23.43 ±23.09) pg/mL](P<0.05).Conclu-sions It is important to examine the thickness and types of endometria by transvaginal ultrasonography and the concentra -tion of LIF in uterine flushing fluid in the previous cycle of IVF-ET for the assessment of endometrial receptivity and predic-tion of IVF-ET outcome.