Endometrial receptivity evaluation using hysteroscopic endometrial gland image recognition

Abstract

We investigated the endometrial gland count on hysteroscopic endometrial images in patients undergoing in vitro fertilization and embryo transfer (IVF-ET) to evaluate endometrial receptivity and predict pregnancy outcomes. Since endometrial receptivity and endometrial glands density are strongly influenced by numerous factors, we selected 98 patients who underwent frozen-thawed embryo transfer (FET) in a natural cycle. Within 1–3 menstrual cycles before embryo transfer, hysteroscopic exploration was performed 3–7 days after ovulation. Uterine cavity morphological data were measured, and hysteroscopic endometrial imaging was performed. An endometrial gland opening labelling algorithm was used to recognize and count the endometrial glands. Patients were divided into pregnancy and non-pregnancy groups based on ET outcomes. No significant differences were noted in patients’ general information and laboratory parameters, including age, years of infertility, body mass index, anti-Müllerian hormone, endometrial thickness and embryos transferred between the two groups. The number of endometrial glands in the pregnancy group was higher than that in the non-pregnancy group (p < 0.05). Hysteroscopic examination of the uterine cavity and gland counting analysis of images using image recognition software can better indicate endometrial receptivity and improve pregnancy outcomes.

Keywords:

• Hysteroscopy
• image recognition
• in vitro fertilization embryo transfer
• endometrial receptivity
• pregnancy outcome

Acknowledgements

We would like to thank Chen Liping, Hu Min and all of the medical colleagues for the great support and help to this research.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Medical Science and Technology Project of Zhejiang Province in 2018 [2018ky713], the Medical and Health Brand Discipline of Ningbo in 2018 [PPXK2018-06] and the Medical Science and Technology Project of Zhejiang Province in 2020 [2020ky881].