The measurement of endometrial volume and sub-endometrial vascularity to replace the traditional endometrial thickness as predictors of in-vitro fertilization success

Abstract

To assess the value of endometrial thickness, volume, and sub-endometrial perfusion in women undergoing IVF. In 82 women candidate for ICSI, endometrial thickness and sub-endometrial perfusion were measured with a trans-vaginal 2 D ultrasound and 3 D power Doppler respectively on day of hCG trigger and Embryo transfer (ET). The primary outcome was the clinical pregnancy rate. Endometrial volume showing a statistically significant difference between pregnant and nonpregnant women (4.11 ± 1.19 vs. 3.4 ± 1.1 p = .019) on day of triggering and at ET (4.02 ± 1.15 vs. 3.45 ± 0.90, p = .022). VFI was significantly higher in pregnant group at both days of triggering and ET (0.54 ± 0.48 vs. 0.33 ± 0.31 and 0.47 ± 0.22 vs. 0.34 ± 0.2, p = .02). At cutoff values of 3.265 and 2.95 cm3 (70 & 80% sensitivity, specificity 64.5 & 51.6%, a positive predictive value 38.9 & 34.8%, and negative predictive value 87.0 & 88.9%) to predict pregnancy on the day of hCG trigger & ET respectively. Cutoff value for Endometrial VFI on the day of ET was 0.674 (sensitivity of 70%, specificity of 80.6%, PPV 53.8%, and NPV 89.3%). Higher endometrial volume and VFI were associated with pregnancy.

摘要

为了评估体外受精女性子宫内膜厚度（mm)、体积(cm³)与子宫内膜下血流灌注(%)的价值。采用经阴道二维超声和三维能量多普勒超声分别在hCG诱发排卵日和胚胎移植日（ET）测量82例ICSI患者子宫内膜厚度和子宫内膜下血流灌注。主要结果是临床妊娠率。妊娠和非妊娠子宫内膜体积在hCG日(4.11±1.19 vs. 3.4±1.1 p=.019)和ET日 (4.02±1.15 vs. 3.45±0.90, p=0.022)差异有统计学意义。妊娠组在hCG日和ET日的VFI均显著升高 (0.54±0.48 vs. 0.33±0.31 和 0.47±0.22 vs. 0.34±0.2, p=0.02)。在hCG日和ET日预测妊娠的截断值分别为3.265和2.95cm³(敏感性70 & 80%, 特异性64.5 & 51.6%, 阳性预测值38.9 & 34.8%, 和阴性预测值87.0 & 88.9%)。ET日子宫内膜VFI的截断值为0.674(敏感性为 70%, 特异性为 80.6%, PPV 53.8%,NPV 89.3%). 较大的子宫内膜体积和较高的VFI与妊娠相关。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• 3 D power Doppler
• IVF
• prediction of pregnancy
• Sub-endometrial perfusion
• VI
• FI
• VFI

Compliance with ethical standards

The study was performed in accordance with the Declaration of Helsinki ethical standards. Informed consents were taken from study participants.

Disclosure statement

The authors report no conflicts of interest in this work.