ارزش تشخیصی یافته‌های کالر داپلر عروق رحمی و تخمدانی در لانه‌گزینی موفقیت‌آمیز رویان در چرخه‌های لقاح آزمایشگاهی

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشیار گروه زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

2 دستیار گروه زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

3 استادیار گروه زنان و زایمان، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

4 استادیار گروه رادیولوژی، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

10.22038/ijogi.2025.82450.6203

چکیده

مقدمه: لقاح آزمایشگاهی یا IVF، یکی از روش­ های تکنولوژی کمک باروری می­ باشد. کلید موفقیت IVF، پذیرش آندومتر برای لانه‌گزینی است. مطالعه حاضر با هدف بررسی ارتباط لانه‌گزینی موفقیت‌آمیز رویان در چرخه­ های لقاح آزمایشگاهی با یافته­ های کالر داپلر عروق رحمی و تخمدانی انجام شد.
روش‌کار: در این مطالعه کوهورت آینده‌نگر که در سال 1403-1402 انجام شد، زنان با مشکل ناباروری کاندید درمان IVF وارد مطالعه شدند. بیماران در روز انجام انتقال جنین، تحت سونوگرافی داپلر عروق رحمی و تخمدانی قرار گرفتند. شاخص مقاومتی و ضربان‌پذیری به همراه ضخامت اندوتلیال رحم ثبت شد. سطح کیفی βhCG روز 12ام به‌عنوان پیامد در نظر گرفته شد. تجزیه و تحلیل داده‌­ها با استفاده از نرم‌افزار آماری SPSS (نسخه 27) و آزمون‌های تی مستقل و فیشر انجام شد. میزان p کمتر از 05/0 معنادار در نظر گرفته شد.
یافته­ ها: میانگین شاخص مقاومتی شریان‌های عروق ساب اندوتلیال رحمی بین دو گروه با پیامد مثبت و منفی IVF تفاوت معنی‌داری داشت (023/0=p). فقط شاخص RI عروق ساب اندوتلیال رحمی به‌طور غیرمعنی‌دار و ضعیف، پیشگویی کننده پیامد موفقیت IVF بود (سطح زیر منحنی راک= 61/0، فاصله اطمینان 95% = 68/0-427/0) (این مقادیر آماری (AUC و فاصله اطمینان 95%) بیانگر قدرت و دقت تشخیصی این شاخص برای تمایز بین پیامد موفق و ناموفق IVF می‌باشند و نشان می‌دهند که این پارامتر برای پیش‌بینی دقیق توانایی محدودی دارد).
نتیجه­ گیری: میانگین شاخص­ های داپلر شریان رحمی و تخمدانی در زنان ناباروری که تحت IVF قرار گرفته و لانه‌گزینی موفقی داشتند نسبت به زنان با IVF بدون لانه ­گزینی موفق، کمتر بود. اگرچه فقط شاخص مقاومتی عروق ساب اندوتلیال به‌طور معنی‌داری متفاوت و پیشگویی کننده موفقیت IVF و لانه­ گزینی ضعیف بود.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Diagnostic Value of Uterine and Ovarian Vascular Color Doppler Parameters in Successful Embryo Implantation during In Vitro Fertilization Cycles

نویسندگان [English]

  • Tahereh Behrouzi-Lak 1
  • Selma Ghorbani 2
  • Somayeh Ghasemzadeh 3
  • Yalda Saniei 4
1 Associate Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
2 Resident, Department of Obstetrics and Gynecology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
3 Assistant Professor, Obstetrics and Gynecology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
4 Assistant Professor, Department of Radiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
چکیده [English]

Introduction: In vitro fertilization (IVF) is one of the assisted reproductive technology methods, and endometrial receptivity is the key to successful IVF embryo implantation. The present study was conducted with aim to evaluate the association between successful embryo implantation in IVF cycles and the findings of color Doppler ultrasound of uterine and ovarian vessels.
Methods: This prospective cohort study was conducted in 2023-2024, enrolling women with infertility problems who were candidates for IVF treatment. On the day of embryo transfer, all patients underwent Doppler ultrasound of uterine and ovarian vessels. The resistance index (RI), pulsatility index (PI), and endometrial thickness were recorded. The qualitative βhCG level on day 12 post-transfer was considered as the main outcome. Data analysis was performed using SPSS (version 27) and independent t and Fisher’s exact tests. P<0.05 was considered statistically significant.
Results: The mean resistance index of subendometrial uterine arteries was significantly different between the groups with positive and negative IVF outcomes (p=0.023). Only the RI of subendometrial uterine arteries weakly and non-significantly predicted IVF success (AUC=0.61, 95% CI: 0.427 – 0.680). These values (AUC and confidence interval 95%) reflect the diagnostic accuracy and power of this index to distinguish between successful and unsuccessful IVF outcomes, but show limited predictive accuracy.
Conclusion: The mean Doppler indices of uterine and ovarian arteries in infertile women who underwent IVF and achieved successful embryo implantation were lower compared to women who underwent IVF without successful implantation. However, only the resistance index of subendometrial vessels was significantly different and a weak predictor of IVF success and implantation outcome.

کلیدواژه‌ها [English]

  • Assisted Reproductive Techniques
  • Color Doppler Ultrasonography
  • Infertility

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 9
آذر 1404
صفحه 22-31

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