基于阴道多普勒超声检查与临床资料构建不明原因不孕患者胚胎反复种植失败的预测模型

doi:10.3969/j.issn.1006-6233.2024.08.030

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Abstract Objective: To construct a predictive model for recurrent embryo implantation failure in unexplained infertility patients based on vaginal Doppler ultrasound examination results and clinical data, and to analyze the influencing factors.Methods: The study group consisted of 198 unexplained infertility patients with recurrent embryo implantation failure from June 2020 to December 2022 at our hospital. The control group included 100 infertility patients with successful embryo implantation during the same period. All patients underwent vaginal Doppler ultrasound examinations. The results of the ultrasound examinations and clinical data were compared between the two groups. Receiver Operating Characteristic (ROC) curve analysis was used to evaluate the predictive value of multiple factors on embryo implantation outcomes. A Logistic regression model was established to identify the influencing factors of recurrent embryo implantation failure and to validate the model.Results: The study group had a higher age, higher AMH levels, higher rate of abnormal autoantibodies, and more induced abortions compared to the control group (P<0.05). The study group had a thinner endometrial thickness on the day of transfer and a higher uterine artery pulsatility index compared to the control group (P<0.05). ROC curve analysis showed that age, AMH, number of induced abortions, autoantibodies, endometrial thickness on the day of transfer, and uterine artery pulsatility index had predictive value for embryo implantation outcomes in infertility patients (AUC=0.706, 0.720, 0.611, 0.649, 0.719, 0.771). The Logistic regression model showed that advanced age, a higher number of induced abortions, abnormal autoantibodies, and a higher uterine artery pulsatility index were risk factors for recurrent implantation failure in infertility patients (OR>1, P<0.05); higher AMH levels and greater endometrial thickness on the day of transfer were protective factors for embryo implantation outcomes (OR<1, P<0.05). The ROC curve drawn based on the Logistic regression model showed that the model's predictive value for recurrent implantation failure in infertility patients was AUC=0.928, P<0.05, indicating that the model was reliable and stable.Conclusion: Recurrent implantation failure in infertility patients may be related to factors such as age, AMH levels, number of induced abortions, autoantibodies, endometrial thickness on the day of transfer, and uterine artery pulsatility index. Clinicians can use transvaginal Doppler ultrasound examination before embryo implantation, combined with clinical data, to comprehensively evaluate the patient's embryo implantation outcomes and take targeted interventions to achieve a favorable pregnancy outcome.

Key words： Infertility Recurrent implantation failure Transvaginal doppler ultrasound Prediction model construction

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2024.08.030 OR http://www.hbyxzzs.cn/EN/Y2024/V30/I8/1390

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