Clinical study on the evaluation of dynamic endometrial morphology and receptivity for IVF-ET pregnancy outcomes of patients with hydrosalpinx infertility

doi:10.11958/20220414

Abstract

Abstract:

Objective To explore the evaluation of dynamic endometrial morphology and receptivity for pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) in patients with hydrosalpinx infertility. Methods A total of 99 patients with hydrosalpinx infertility were enrolled. All were given antagonist regimens for assisted reproduction. According to the first IVF-ET pregnancy outcomes, patients were divided into the pregnancy group (43 cases) and the non-pregnancy group (56 cases). The endometrial morphology and hemodynamic indexes were compared between the two groups. The specimens of endometrial biopsy in implantation window of oocyte retrieval period were collected to detect the expressions of homeobox gene A10 (HOXA10) and integrin α_vβ3 by immunohistochemical staining. Results There were no significant differences in uterine position and endometrial morphology between the two groups (P>0.05). On the start day of COH cycle (D1), uterine artery PI was lower in the pregnancy group than that in the non-pregnancy group. On the day of HCG injection (D2), endometrial thickness was greater in the pregnancy group than that in the non-pregnancy group, and uterine artery PI and RI were lower in the pregnancy group than those in the non-pregnancy group (P<0.01). The expression levels of HOXA10 and integrin α_vβ3 in endometrial tissue were significantly higher in the pregnancy group than those in the non-pregnancy group (P<0.05). On D2, the expression of RI in uterine artery, HOXA10 and integrin α_vβ3 in endometrial tissue were independent factors influencing pregnancy outcomes of IVF-ET (P<0.05). The expression levels of HOXA10 and integrin α_vβ3 in endometrial tissue were of certain predictive value for IVF-ET pregnancy, and the area under the curve (AUC) were 0.778 (95%CI: 0.681-0.874) and 0.779 (95%CI: 0.685-0.873), respectively. Conclusion The endometrial receptivity indexes HOXA10 and α_vβ3 have a positive predictive effect on pregnancy outcomes of IVF-ET in patients with hydrosalpinx infertility.

Key words: fertilization in vitro, embryo transfer, pregnancy outcome, hydrosalpinx infertility, endometrial morphology, endometrial receptivity

CLC Number:

R711.76

Figures/Tables 6

References 19

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组别	n	年龄（岁）	不孕年限（年）	BMI （kg/m²）	基础窦卵泡数（个）	抗苗勒管激素（μg/L）	促卵泡激素（IU/L）	促黄体生成素（IU/L）	雌二醇（ng/L）	促性腺激素用量（U）
妊娠组	43	30.23±3.46	3.88±1.15	21.42±2.46	3.56±0.81	0.70±0.23	7.25±1.95	4.65±1.02	31.52±6.89	2 716.58±680.54
未妊娠组	56	30.92±3.38	4.12±1.28	22.26±2.65	3.39±0.92	0.64±0.21	6.52±2.10	4.51±1.18	33.67±7.24	2 721.32±711.47
t		1.100	0.966	1.612	0.959	1.352	1.768	0.620	1.495	0.033

组别	n	年龄（岁）	不孕年限（年）	BMI （kg/m²）	基础窦卵泡数（个）	抗苗勒管激素（μg/L）	促卵泡激素（IU/L）	促黄体生成素（IU/L）	雌二醇（ng/L）	促性腺激素用量（U）
妊娠组	43	30.23±3.46	3.88±1.15	21.42±2.46	3.56±0.81	0.70±0.23	7.25±1.95	4.65±1.02	31.52±6.89	2 716.58±680.54
未妊娠组	56	30.92±3.38	4.12±1.28	22.26±2.65	3.39±0.92	0.64±0.21	6.52±2.10	4.51±1.18	33.67±7.24	2 721.32±711.47
t		1.100	0.966	1.612	0.959	1.352	1.768	0.620	1.495	0.033

组别	n	子宫位置			子宫内膜形态
组别	n	前位	水平位	后位	A型	B型	C型
妊娠组	43	25（58.14）	9（20.93）	9（20.93）	23（53.49）	11（25.58）	9（20.93）
未妊娠组	56	39（69.64）	9（16.07）	8（14.29）	32（57.14）	15（26.79）	9（16.07）
χ²		1.439			0.388

组别	n	子宫位置			子宫内膜形态
组别	n	前位	水平位	后位	A型	B型	C型
妊娠组	43	25（58.14）	9（20.93）	9（20.93）	23（53.49）	11（25.58）	9（20.93）
未妊娠组	56	39（69.64）	9（16.07）	8（14.29）	32（57.14）	15（26.79）	9（16.07）
χ²		1.439			0.388

组别		n	子宫内膜厚度（mm）
组别		n	D1			D2
妊娠组		43	5.49±0.18			12.42±0.35
未妊娠组		56	5.42±0.22			11.06±0.29
t			1.695			21.134^＊＊
组别	子宫动脉PI				子宫动脉RI
组别	D1			D2	D1		D2
妊娠组	2.15±0.11			1.93±0.15	0.83±0.09		0.73±0.12
未妊娠组	2.37±0.21			2.24±0.19	0.86±0.13		0.82±0.15
t	6.239^＊＊			8.796^＊＊	1.293		3.221^＊＊