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Evaluation of Ovarian Response and Endometrial Receptivity by Ultrasound and Its Relationship with IVF-ET Outcome

Author: ZhaoMin
Tutor: ChangCai;LiuZhi;WangCheng
School: Fudan University
Course: Obstetrics and Gynaecology
Keywords: Transvaginal Color Doppler Ovarian response Ovarian volume Antral follicle count Ovarian stromal artery PI RI Follicular fluid NO ET-1 VEGF Endometrial receptivity Endometnal thickness Endometrial pattern Aspirin LIF Integrinβ3
CLC: R714.8
Type: PhD thesis
Year: 2007
Downloads: 349
Quote: 0
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Abstract


IVF-ET(in vitro fertilization and embryo transfer)is a commonly used methods to treat infertility.At present,the technology of IVF-ET has been raised,the rate of oocyte recovery and embryo transfer have been raised too,however pregnancy rate still remains 30~40%.So many scholars have been paying close attention to raising pregnancy rate.Among many factors which can impact IVF-ET outcome,ovarian response and endometrial receptivity are very important.We want to evaluate ovarian response by measuring ovarian volume,antral follicle count and ovarian stromal blood flow by transvaginal color Doppler and level of follicular fluid NO,ET-1,VEGF.We want to evaluate endometrial receptivity by measuring endometrial thickness,pattern and uterine artery blood flow by transvaginal Doppler.In a word,we want to predict IVF-ET outcome by ovarian response and endometrial receptivity.Moreover,we want to discover that low-dose aspirin can improve endometrial receptivity by detecting the expression of LIF and integrinβ3,then provide histological evidence for the application of aspirin in ART(assisted reproductive technology). PartⅠEvaluation of ovarian response during IVF-ET using transvaginal color Doppler and level of follicular fluid NO,ET-1,VEGFObjective:To investigate the role of ovarian volume,antral follicle count and ovarian stromal blood flow and level of follicular fluid NO,ET-1,VEGF in assessing ovarian response in an IVF program.Methods:131 patients undergoing IVF cycles were recruited.Transvaginal color Doppler was performed on the priming day and HCG injection day to determine ovarian volume,antral follicle count,PI and RI of ovarian stromal artery. The level of follicular fluid NO,ET-1,VEGF were measured too.Results:The pregnancy rate was 37.40%(49/131).Total ovarian volume, antral follicle count on the priming day and HCG injection day were significantly higher in the pregnant group than those in the non-pregnant group.(P<0.05) Ovarian stromal artery PI,RI on the priming day and HCG injection day were significantly lower in the pregnant group than those in the non-pregnant group.(P <0.05)There were significantly increased level of follicular fluid NO,VEGF and decreased level of follicular fluid ET-1 in the pregnant group than those in the non-pregnant group.(P<0.05)Conclusions:Ovarian volume,antral follicle count,ovarian stromal artery PI, RI measured by Doppler and level of follicular fluid NO,ET-1,VEGF were good predictors of ovarian response in IVF-ET. PartⅡEvaluation of endometrial receptivity during IVF-ET using transvaginal color DopplerObjective:To investigate the role of endometrial thickness,pattern and uterine artery blood flow in assessing endometrial receptivity in an IVF program.Methods:131 patients undergoing IVF cycles were recruited.Transvaginal color Doppler was performed on the priming day and HCG injection day to determine endometrial thickness,endometrial pattern,PI and RI of uterine artery.Results:The pregnancy rate was 37.40%(49/131).When endometrial thickness on the priming day and HCG injection day was 3~8mm,8~17mm,the thicker endometrial thickness was,the higher the pregnancy rate was.Minimum endometrial thickness on HCG injection day associated with pregnancy was 7mm, maximum endometrial thickness on the priming day and HCG injection day were 9mm and 18mm,respectively.In those who had a triple-line pattern on HCG injection day,the pregnancy rate was 46.34%,and it was 22.45%in those with a homogeneous pattern.(P<0.05)Uterine artery PI,RI on the priming day and HCG injection day were significantly lower in the pregnant group than those in the non-pregnant group.(P<0.05)Conclusions:Endometrial thickness,pattern and uterine artery PI,RI measured by Doppler were good predictors of endometrial receptivity in IVF-ET. PartⅢExperimental study of aspirin on improving endometrial receptivity in miceObjective:To discover the effect of low-dose aspirin on endometrial receptivity in mice.Methods:Experimental animals(KM mouse)were divided into two groups: experimental(aspirin)group and control(normal sodium)group.We got endometrial tissue of mice who was pregnant on the fourth day(nidation window). The expression of protein and mRNA of LIF and integrinβ3 were detected by Fluorescence-immunohistochemistry and real-time PCR.Results:The expression of LIF and integrinβ3 were significantly higher in experimental group than those in control group.(P<0.05)Conclusions:Low-dose aspirin can improve endometrial receptivity in mice.

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