Ultrasonography and Doppler Study to Predict Uterine Receptivity in Infertile Patients Undergoing Embryo Transfer

Abstract

About the Author AbstractPurpose To detect whether ultrasonographic parameters and Doppler analysis of uterine blood flow can be of value in the prediction of endometrial receptivity in infertile female patients undergoing embryo transfer. Methods In this study, a total of 200 women with primary infertility undergoing embryo transfer were analyzed. Transvaginal ultrasonography was done on the 10th day of the menstrual cycle. To assess the uterine receptivity, we analyzed all the ultrasonographic and Doppler parameters. The slightly modified version of Applebaum Uterine Scoring System was used. This uterine scoring system included all the following parameters: endometrial thickness, endometrial morphology, endometrial blood flow within zone 3, myometrial echogenecity, uterine artery pulsatility index (PI), end diastolic blood flow, and myometrial blood flow internal to the arcuate vessels seen on gray-scale examination. Results The pregnancy rates were higher in women with thick, distinct five-line endometrium and multifocal endometrial vascularity within zone 3. Absent endometrial flow, despite highest values for the other parameters, was associated with no conception. In our study, no pregnancy occurred with uterine PI values of more than 2.8. Absence or reversal of end diastolic blood flow was associated with no conception. A maximum score of 20 was associated with the pregnancy rate of 97.4 %, whereas scores of 13 or less resulted in no pregnancies. 123Conclusion Uterine scoring system will help to perform embryo transfers in only favorable uteri and postpone or cancel those cycles in which poor uterine score is demonstrated.

Impact of letrozole versus clomiphene citrate on endometrial receptivity in Iraqi women with polycystic ovarian syndrome

“…5 Although we noticed that levels of the sub-endometrial blood RI in the pregnant group were significantly lower as compared to the non-pregnant group in both study groups, but it was much less in the letrozole as compared to the CC group. 10 In addition, the correlation between VEGF and RI in the letrozole group was significantly negative, improving the endometrial receptivity in the letrozole group, which can be attributed to the increased endometrial VEGF levels with subsequent improved vascularization. 20,22 Clomiphene citrate can downregulate the VEGF production, which may in part be due to its anti-oestrogenic effects.…”

“…This can be partially explained due to the fact that these vascular changes play a significant role in the implantation process as they are present from the beginning of the embryo nidation stage . Previous studies showed that good blood supply to the sub‐endometrial halo and to the endometrium results in a thicker endometrial wall maximizing the chance of pregnancy …”

“…9 Previous studies showed that good blood supply to the sub-endometrial halo and to the endometrium results in a thicker endometrial wall maximizing the chance of pregnancy. 10…”

Uterine scoring system for reproduction scoring correlation with pregnancy rate in infertility patients undergoing intracytoplasmic sperm injection and embryo transfer

“…[9][10][11] Most suitable endometrial thickness was 10-14mm, followed by 7-9mm. 5 Endometrium <6 mm is associated with no conception. We found decreased pregnancy rate in patients with endometrial thickness more than 14mm.…”

“…Distinct five line or triple layer pattern of endometrium shows better implantation rate as compared to hazy, homogenous endometrium shown in Table 3. 4,5 Endometrial thickness and subendometrial blood flow patterns are useful prognostic parameters for successful pregnancy. Endometrial blood flow was directly correlated with pregnancy outcome following embryo transfer.…”