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| Elevated progesterone on HCG day and its effect on the endometrium evaluated by three-dimensional power Doppler flow imaging |
| ZHANG Yinhong, ZHAO Yaping, ZHOU Xiuping. |
| Department of Ultrasonography, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, China |
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| Cite this article: |
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ZHANG Yinhong,ZHAO Yaping,ZHOU Xiuping.. Elevated progesterone on HCG day and its effect on the endometrium evaluated by three-dimensional power Doppler flow imaging[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2021, 51(3): 220-224,229.
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Abstract Objective: To study the elevated progesterone on the day of HCG injection in in vitro fertilization and embryo transfer (IVF-ET) treatment and its effect on the endometrium and its correlation with pregnancy outcome. Methods: Transvaginal three-dimensional power Doppler flow imaging ultrasound (3D-PDI) was used to examine 180 patients who were treated with IVE-ET at the Reproductive Center of the Second Affiliated Hospital of Wenzhou Medical University from February to September 2018. Data of their endometrial thickness, echo, endometrial blood flow classification and endometrial volume, endometrial vascularization index (VI), blood flow index (FI) and vascularized blood flow index (VFI) were obtained, and the serum progesterone value on HCG day elevation. According to ROC curve analysis, the cut-off value of HCG day progesterone measured was divided as the elevated progesterone group followed by an analysis of parameters and its correlation with pregnancy outcomes. Results: Of 180 cases, 84 were successful and became pregnant group, 5 biochemical pregnancy, 2 ectopic pregnancy, 89 cases were not pregnant and became non-pregnant group. The clinical pregnancy rate was about 46.6%. ROC curve analysis showed the cut-off value of elevated progesterone was 1.29 ng/mL. There were 59 cases in the elevated progesterone group and 121 cases in the normal progesterone group, showing no significant difference in age and endometrial FI between the two groups (P>0.05). In the elevated progesterone group, the proportion of type C endometrium and the type I blood flow were higher than the normal progesterone group, while the proportion of type III blood flow was lower than the normal progesterone group, with statistical difference (P<0.05). The endometrial thickness, endometrial volume, endometrial VI and VFI in the elevated progesterone group were lower than those in the normal progesterone group (P<0.05). There was no significant difference in age, endometrial thickness, endometrial volume and endometrial FI between the pregnant group and the non-pregnant group (P>0.05). The endometrial VI and VFI of the pregnant group were higher than those of the non-pregnant group (P<0.05). The pregnancy rate of type A, type B and type C endometrial
echo decreased sequentially, while the pregnancy rate of type I, type II and type III endometrial blood flow increased sequentially, with significant difference (P<0.05). Conclusion: Elevated progesterone on HCG day in IVF-ET will lead to an increased proportion of type C endometrium, decreased endometrial blood perfusion and
endometrial vascularization, which is not conducive to successful pregnancy.
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Received: 26 August 2020
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