CAJ | 학술논문

目的探讨体外受精-胚胎移植(IVF/ICSI)过程中子宫收缩对妊娠结局的影响.方法选取86例行IVF/ISCI治疗的不孕症患者作为研究对象,分别于注射人绒毛膜促性腺激素(HCG)日和胚胎移植(ET)日,经阴道超声监测患者子宫内膜厚度、子宫收缩波形及频率,并在移植日测定血清雌激素(E 2)、孕酮(P )值.根据其妊娠结局分为临床妊娠组和非妊娠组,分析各因素与妊娠结局的相关性.结果 HCG日临床妊娠组与非妊娠组的子宫内膜厚度、子宫收缩波形构成比及收缩频率相比,差异均无统计学意义(P>0.05);ET日2组内膜厚度比较,差异无统计学意义(P>0.05);而2组不同妊娠结局间的子宫收缩波形构成比以及子宫收缩频率之间的差异有统计学意义(P<0.05),显示临床妊娠组较非妊娠组子宫收缩的正向运动较多,而非妊娠组的不规则运动和负向运动更多,临床妊娠组子宫收缩频率≤4次/min较非妊娠组更多;将ET日的子宫收缩波形与频率引入Logis-tic回归分析后,结果显示收缩频率(P<0.05)是妊娠与否的影响因素,可见收缩频率太强不易妊娠.结论接受IVF/ICSI治疗后,子宫内膜厚度对妊娠结局影响不大;注射HCG日子宫收缩的波形及频率对妊娠结局影响不大;ET日子宫收缩波形及频率与临床妊娠率有明显的相关性,收缩频率太强不易妊娠.
목적 탐토체외수정-배태이식(IVF/ICSI)과정중자궁수축대임신결국적영향.방법 선취86례행IVF/ISCI치료적불잉증환자작위연구대상,분별우주사인융모막촉성선격소(HCG)일화배태이식(ET)일,경음도초성감측환자자궁내막후도、자궁수축파형급빈솔,병재이식일측정혈청자격소(E 2)、잉동(P )치.근거기임신결국분위림상임신조화비임신조,분석각인소여임신결국적상관성.결과 HCG일림상임신조여비임신조적자궁내막후도、자궁수축파형구성비급수축빈솔상비,차이균무통계학의의(P>0.05);ET일2조내막후도비교,차이무통계학의의(P>0.05);이2조불동임신결국간적자궁수축파형구성비이급자궁수축빈솔지간적차이유통계학의의(P<0.05),현시림상임신조교비임신조자궁수축적정향운동교다,이비임신조적불규칙운동화부향운동경다,림상임신조자궁수축빈솔≤4차/min교비임신조경다;장ET일적자궁수축파형여빈솔인입Logis-tic회귀분석후,결과현시수축빈솔(P<0.05)시임신여부적영향인소,가견수축빈솔태강불역임신.결론 접수IVF/ICSI치료후,자궁내막후도대임신결국영향불대;주사HCG일자궁수축적파형급빈솔대임신결국영향불대;ET일자궁수축파형급빈솔여림상임신솔유명현적상관성,수축빈솔태강불역임신.
Objective To investigate the effects of uterine contraction on pregnancy outcome in in-vitro fertil-ization/intracytoplasmic sperm injection (IVF/ICSI) cycle. Methods Eighty-six patients with infertility underwent IVF/ISCI treatment were included as the subjects in the study. The endometrial thickness, and waveform and frequency of uterine contraction were determined by transvaginal ultrasound on the human chorionic gonadotropin (HCG) injection day and embryo transplantation (ET) day, respectively. The serum estrogen (E 2) and progesterone (P) value were mea-sured on the ET day. All patients were divided into the clinical pregnant group and non-pregnant group according to their pregnancy outcomes. The correlation between the factors and the pregnancy outcome was analyzed. Results There were no statistically significant differences in the endometrial thickness, and waveform and frequency of uterine contraction between the clinical pregnant group and the non-pregnant group on the HCG injection day (P>0.05);whereas no statistically significant difference was found in the endometrial thickness between the two groups on the ET day (P>0.05). There were statistically significant differences in the waveform and frequency of uterine contraction of different pregnancy outcomes between the two groups (P<0.05), showing that the clinical pregnant group had more positive movements and less irregular and negative movements of uterine contraction than the non-pregnant group. More cases with frequency of uterine contraction ≤4 times/minute were found in the clinical pregnant group than the non-pregnant group. The logistic regression analysis of uterine contraction waveform and frequency on the ET day showed that the contraction waveform was P>0.05 but the contraction frequency was P<0.05, suggesting that high con-traction frequency was the main cause to infertility, based on the two different pregnancy outcomes. Conclusion There are less effects of endometrial thickness on the pregnancy outcomes in patients of the two groups after receiving IVF/ICSI treatment. Also, less effects of uterine contraction waveform and frequency on the pregnancy outcomes on the HCG injection day are found. There are significant correlations between the waveform and frequency of uterine con-traction on the ET day and the clinical pregnancy rate. High uterine contraction frequency is the main cause to infer-tility.