II-184 ZDRAV VESTN 2003; 72: SUPPL II
POMEN ULTRAZVOČNIH ZNAČILNOSTI
ENDOMETRIJA PRI NAPOVEDOVANJU VGNEZDITVE
ZARODKOV V POSTOPKIH ZUNAJTELESNE
OPLODITVE V NARAVNEM CIKLUSU
PREDICTIVE VALUE OF ECHOGRAPHIC CHARACTERISTICS OF ENDOMETRIUM ON
IMPLANTATION RATE IN IN-VITRO FERTILISATION IN UNSTIMULATED CYCLE
Lucija Kuder1, Veljko Vlaisavljević2, Milan Reljič2
1 Oddelek za perinatologijo, Služba za ginekologijo in perinatologijo, Splošna bolnišnica Maribor, Ljubljanska 5,
2000 Maribor
2 Oddelek za reproduktivno medicino in ginekološko endokrinologijo, Splošna bolnišnica Maribor, Ljubljanska 5,
2000 Maribor
Key words: in vitro fertilization; natural cyclus; sonographic
endometrial characteristics; embryo implantation
Abstract – Background. The purpose of this study was to de-
termine whether endometrial features such as thickness, type
and subendometrial movements observed by ultrasound on
the day of embrio transfer in in vitro fertilisation (IVF) in
natural cycles, can predict implantation outcome.
Methods. One hundred and eight natural IVF cycles in which
the embrio transfer was performed were included in a pro-
spective study.
One hour prior embryo transfer vaginal ultrasound exami-
nation was done to measure endometrial thickness, asses en-
dometrial patern and movements. The thickness and type of
endometrium were estimated in sagital plane of the uterus.
Estimation of the direction of movements, amplitude and the
amount of waves regarding the length of uterin cavity were
performed.
Women were divided into two groups: the first group consi-
sted of those who concived and the second of those who did
not.
Results. The average age of women was 32.8 ± 4.07 years.
Both groups were comparable in therms of age, estradiol level
and average follicle diameter on the day of hCG application.
Pregnancy rate on embryo transfer being 22.2% (24/108),
and 84 women (77.8%) did not conceived. The thickness, type
end endometrial movements were similar in both groups, the-
refore, not statistical significant (p>0.05). Duration of men-
strual cycle prior to hCG application on concived group was
shorter, statistically significant (p = 0.002).
Conclusions. On the basis owing to ultrasound characteristics
such as subendimetrial movements, thickness and pattern on
the day of embrio transfer in the natural IVF cycle have no
predictive value of embryo implantation.
Ključne besede: in vitro fertilizacija; naravni ciklus; ultra-
zvočne značilnosti endometrija; vgnezditev zarodka
Izvleček – Izhodišča. Namen raziskave je bil ugotoviti, ali z
ultrazvočnimi značilnostmi endometrija, kot so debelina, tip,
in gibanje subendometrija, na dan prenosa zarodka v po-
stopku zunajtelesne oploditve (IVF) v naravnem ciklusu lah-
ko napovemo možnost vgnezditve zarodka.
Metode. V prospektivno raziskavo smo vključili 108 narav-
nih ciklusov IVF, pri katerih je prišlo do prenosa zarodka.
Eno uro pred prenosom zarodkov smo z vaginalnim ultra-
zvokom merili debelino endometrija, ocenjevali izgled in
gibanje endometrija. Debelino in tip endometrija smo ocenje-
vali v sagitalni ravnini uterusa. Ocenili smo smer gibanja,
amplitudo in obseg valovanja glede na dolžino maternične
votline. Ženske smo razdelili v dve skupini: prvo skupino
so tvorile ženske, ki so zanosile, in drugo ženske, ki niso za-
nosile.
Rezultati. Povprečna starost je bila 32,8 ± 4,07 leta. Obe sku-
pini sta bili primerljivi po starosti, bazalnih vrednostih FSH,
serumskih koncentracijah estradiola in povprečnem preme-
ru folikla na dan dajanja hCG. Stopnja zanositve na prenos
zarodka je bila 22,2% (24/108), 84 (77,8%) žensk pa ni bilo
nosečih.
Debelina in tip endometrija ter smer, obseg in amplituda gi-
banja endometrija so bili podobni v obeh skupinah in se sta-
tistično pomembno niso razlikovali (p>0,05). Trajanje men-
struacijskega ciklusa pred dajanjem hCG v skupini nenose-
čih je bilo statistično pomembno krajše (p = 0,002).
Zaključki. Na osnovi ugotavljanja ultrazvočnih značilnosti
endometrija, kot so debelina in tip ter gibanje na dan preno-
sa zarodka v postopku zunajtelesne oploditve v naravnem
ciklusu, ne moremo predvideti možnosti vgnezditve zarodka.