王小红,枚芳芳,谢玉玲,王丹彤,王莉云

在人类辅助生殖技术中，胚胎质量和子宫内膜容受性是影响胚胎种植结局的关键因素，良好的子宫内膜容受性是胚胎着床的必要条件。目前子宫内膜容受性阵列（Endometrial Receptivity Array，ERA）检测技术被认为是诊断子宫内膜容受性最客观、最准确的方法，但其为侵入性检查，且花费较高。而经阴道超声作为临床普及的非创伤性检查，使用简便、快速，且可连续动态监测子宫内膜参数变化评估子宫内膜容受性。本文就经阴道彩色多普勒超声检测子宫内膜厚度、形态、容积、子宫内膜血流灌注、子宫动脉血流及子宫内膜蠕动评估子宫内膜容受性的研究新进展进行总结。

子宫内膜容受性；经阴道超声；生殖技术，辅助；胚胎植入；子宫内膜

[1] Lessey B A,Young S L.What exactly is endometrial receptivity?[J].Fertility and sterility,2019,111（4）:611-617. [2] 段霞,王治鸿.评估子宫内膜容受性的研究进展[J].中国计划生育和妇产科,2022,14(11):30-34. [3] Liao Z,Liu C,Cai L,et al.The effect of endometrial thickness on pregnancy,maternal,and perinatal outcomes of women in fresh cycles after IVF/ICSI:a systematic review and meta-analysis[J].Frontiers in endocrinology,2022,12:814648. [4] Moshkalova G,Karibayeva I,Kurmanova A,et al.Endometrial thickness and live birth rates after IVF:a systematic review[J].Acta Bio Medica:Atenei Parmensis,2023,94(3). [5] Wang S,Qi L,Liu Y,et al.Suitable endometrial thickness on embryo transfer day may reduce ectopic pregnancy rate and improve clinical pregnancy rate[J].BMC Pregnancy and Childbirth,2023,23(1):517. [6] Kasius A,Smit J G,Torrance H L,et al.Endometrial thickness and pregnancy rates after IVF:a systematic review and meta-analysis[J].Human reproduction update,2014,20(4):530-541. [7] Mathyk B,Schwartz A,DeCherney A,et al.A critical appraisal of studies on endometrial thickness and embryo transfer outcome[J].Reproductive BioMedicine Online,2023:103259. [8] Maged A M,Kamel A M,Abu-Hamila F,et al.The measurement of endometrial volume and sub-endometrial vascularity to replace the traditional endometrial thickness as predictors of in-vitro fertilization success[J].Gynecological Endocrinology,2019,35(11):949-954. [9] Liu Y,Yue Q,Wang L,et al.Using 2D/3D ultrasound observation of endometrial thickness,endometrial volume,and blood flow changes to predict the outcome of frozen embryo transfer cycles:a prospective study[J].Quantitative Imaging in Medicine and Surgery,2023,13(6):3915. [10] Li X,Peng Y,Mao Y,et al.Endometrial receptivity change:ultrasound evaluation on ovulation day and transplantation day during the natural frozen embryo transfer cycle[J].Frontiers in Endocrinology,2023,14:1118044. [11] Lam M T,Li H W R,Ng E H Y.Impact of endometrial thickness and volume compaction on the live birth rate following fresh embryo transfer of in vitro fertilization[J].Journal of Ultrasound in Medicine,2022,41(6):1455-1463. [12] Hazari V,Sarvi F,Alyasin A,et al.Enhancing endometrial receptivity in FET cycles:exploring the influence of endometrial and subendometrial blood flow along with endometrial volume[J].Frontiers in Medicine,2024,11:1260960. [13] Liao S,Wang R,Hu C,et al.Analysis of endometrial thickness patterns and pregnancy outcomes considering 12,991 fresh IVF cycles.BMC Med Inform Decis Mak.2021 Jun 3;21(1):176. [14] Zhao Y,Xu A,Liu D,et al.An endometrium of type C along with an endometrial thickness of<8 mm are risk factors for ectopic pregnancy after stimulated cycles with fresh embryo transfer[J].BMC Pregnancy and Childbirth,2023,23(1):713. [15] Yang W,Zhang T,Li Z,et al.Combined analysis of endometrial thickness and pattern in predicting clinical outcomes of frozen embryo transfer cycles with morphological good-quality blastocyst:A retrospective cohort study[J].Medicine,2018,97(2):e9577. [16] Shalom-Paz E,Atia N,Atzmon Y,et al.The effect of endometrial thickness and pattern on the success of frozen embryo transfer cycles and gestational age accuracy[J].Gynecological Endocrinology,2021,37(5):428-432. [17] Zhang Q,Wang X,Li Z,et al.Association between endometrial blood and clinical outcome in frozen single blastocyst transfer cycles[J].Frontiers in Physiology,2023,14:1113853. [18] Bahrami F,Eftekhar M,Zanbagh L.Uterine artery Doppler and endometrial blood flow in frozen embryo transfer:A cohort study[J].International Journal of Reproductive BioMedicine,2023,21(3):205. [19] Bayati F,Eftekhar M,Homayoon N,et al.Comparison of Doppler ultrasound indices of uterine artery and sub endometrial blood supply in frozen embryo transfer with and without repeated implantation failure:A cross-sectional study[J].International Journal of Reproductive BioMedicine,2023,21(11):937. [20] Sadek S,Matitashvili T,Kovac A,et al.Assessment of uterine receptivity by endometrial and sub-endometrial blood flow using Slow flow HD in hormone prepared frozen embryo transfer cycles:a pilot study[J].Journal of Assisted Reproduction and Genetics,2022,39(5):1069-1079. [21] Tian Y,Yang X.A review of roles of uterine artery Doppler in pregnancy complications[J].Frontiers in Medicine,2022,9:813343. [22] Yu J,Li B,Li H,et al.Comparison of uterine,endometrial and subendometrial blood flows in predicting pregnancy outcomes between fresh and frozen-thawed embryo transfer after GnRH antagonist protocol:A retrospective cohort study[J].Journal of Obstetrics and Gynaecology,2023,43(1):2195937. [23] Yang W,Wu Z,Yu M,et al.Characteristics of midluteal phase uterine artery hemodynamics in patients with recurrent pregnancy loss.J Obstet Gynaecol Res.2019 Jul;45(7):1230-1235. [24] Fan J,Zhang J,Xu S,et al.The predictive value of uterine artery Doppler in the success rate of pregnancy from the first frozen embryo transfer during the implantation window[J].BMC Pregnancy and Childbirth,2023,23(1):825. [25] Li L,Du M,Wu S,et al.Analysis of the uterine artery pulsatility index on the day of endometrial transformation and pregnancy outcomes of patients undergoing frozen–thawed embryo transfer[J].Frontiers in Endocrinology,2024,15:1278504. [26] Lloyd-Davies C,Collins S L,Burton G J.Understanding the uterine artery Doppler waveform and its relationship to spiral artery remodelling[J].Placenta,2021,105:78-84. [27] Moliner B,Llacer J,Sellers F,et al.4D ultrasound as a method to assess uterine peristalsis[J].Fertility and Sterility,2021,116(1):272-274. [28] Masroor M J,Asl L Y,Sarchami N.The Effect of Uterine Contractions on Fertility Outcomes in Frozen Embryo Transfer Cycles:A Cohort Study[J].Journal of Reproduction&Infertility,2023,24(2):132. [29] Chung C H S,Wong A W Y,Chan C P S,et al.The changing pattern of uterine contractions before and after fresh embryo transfer and its relation to clinical outcome[J].Reproductive biomedicine online,2017,34(3):240-247. [30] Zhang C,Chen C,Wang J,et al.An endometrial receptivity scoring system basing on the endometrial thickness,volume,echo,peristalsis,and blood flow evaluated by ultrasonography[J].Frontiers in Endocrinology,2022,13:907874.

点击下载PDF