The usefulness of endometrial thickness, morphology and vasculature by 2D Doppler ultrasound in prediction of pregnancy in IVF/ICSI cycles

Abstract

Objective: The aim of this study was to assess the predictive value of endometrial thickness, morphology and vasculature using two-dimensional (2D) Doppler ultrasound on the IVF/ICSI cycle outcome. Subjects and methods: Endometrial thickness, morphology and subendometrial blood flow were assessed using transvaginal ultrasound on the day of hCG in 100 patients undergoing IVF/ICSI treatment in the period between June 2013 and January 2015. Statistical analysis was done. Results: There was no difference in the demographic features or details of ovarian stimulation between pregnant and non-pregnant women. Overall, 40 patients conceived; 23 (57.5%) of them had blood flow in zone III and 15 (37.5%) in zone II. All patients achieved pregnancy had endometrial thickness >8 mm. Using the ROC curve, the cutoff endometrial thickness for non-achieving pregnancy was 7 mm with a sensitivity and specificity of 100%. There was no significant difference in Doppler indices between pregnant and non-pregnant women. Conclusion: When the endometrial thickness is <8 mm, and if there are non-triple endometrial line and non-favorable blood flow zone on day of hCG in IVF/ICSI cycles, pregnancy is unlikely and embryo transfer should be canceled with freezing of all embryos for future transfer to increase the success rate.

Uterine Artery and Endometrial Doppler Velocimetry before Embryo Transfer in Intra-cytoplasmic Sperm Injection: Influence on Cycle Success

“…Kader et al (25) A prospective observational investigation was also conducted on 100 IVF/ICSI women, and the findings showed that there was no statistically important distinctions in the Doppler indices of the sub-endometrial blood vessels between pregnant and non-pregnant women when EMT, morphology, and subendometrial blood flow were assessed using TVUS on the day of hCG.…”

Endometrial Sonographic Parameters in Prediction Of Intracytoplasmic Sperm Injection Outcome Following Fresh Embryo Transfer In Normal Responders: a Cohort Study

“…Our study was conducted at a private fertility and IVF center in Zagazig, Egypt, during the period From September 2020 to March 2022. Assuming the difference in pregnancy rate is 10.1% and 23.92 % based on two different endometrial thickness groups, the Sample size was 262 patients using open Epi at confidence 95% and power 80% [2].…”

“…Both endometrial receptivity and the quality of the embryo remain important predictors of ICSI success [1]. Endometrial receptivity is a key stage in embryo implantation, and ultrasound is considered a simple and appreciated technique in the evaluation of endometrium before embryo transfer [2]. The implantation success depends on harmony between the blastocyst and the endometrium [3].…”

AIUM Practice Parameter for the Performance of a Focused Ultrasound Examination in Reproductive Endocrinology and Female Infertility

“…The measurement of the thickest portion of the endometrium should be done with calipers perpendicular to the uterus in the anteroposterior diameter from echogenic to echogenic border (outer edge to outer edge of the endometrium). 3,4 The adjacent hypoechoic myometrium and fluid in the cavity should be excluded. The appearance of the endometrium may be described.…”

“…In each ultrasound examination, the uterine endometrium should be imaged in the sagittal plane (or longitudinal plane). The measurement of the thickest portion of the endometrium should be done with calipers perpendicular to the uterus in the anteroposterior diameter from echogenic to echogenic border (outer edge to outer edge of the endometrium) . The adjacent hypoechoic myometrium and fluid in the cavity should be excluded.…”