DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20171402

Prediction of pregnancy in artificial reproductive techniques through evaluation of thickness, morphology and vascularity of endometrium

Aditya Prakash Misra, Ritu Mishra

Abstract


Background: Prediction of pregnancy in Artificial Reproductive Techniques through evaluation of thickness, morphology and vascularity of endometrium.

Methods: Endometrial thickness, morphology and sub endometrial blood flow were assessed using trans-vaginal ultrasound on the day of HCG in 200 undergoing IVF/ICSI treatment in the period between October 2009 and December 2014. Statistical analysis was done.

Results: There was no difference in the demographic features between pregnant and non-pregnant women. Overall, 80 patients conceived; 46 (57.5%) of them had blood flow in zone III and 30 (37.5%) in zone II. All patients achieved pregnancy had endometrial thickness >8 mm. There was no significant difference in Doppler indices between pregnant and non-pregnant women.

Conclusions: When the endometrial thickness is <8 mm, and if there are non-triple endometrial line, pregnancy rate decreases and the absence of colour mapping of the endometrium and subendometrial areas means and absolute implantation failure or a significant decrease of the implantation rate. Conversely, the pregnancy rate increases when the vessels reach endometrium.


Keywords


Artificial reproductive techniques, Endometrial vascularity, Pregnancy

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References


Merce LT, Barco MJ, Bau S, Troyano J. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome? Fertil Steril. 2008;89(1):111-7.

Singh N, Bahadur A, Mittal S, Malhotra N, Bhatt A. Predictive value of endometrial thickness, pattern and sub-endometrial blood flows on the day of HCG by 2D doppler in in-vitro fertilization cycles: a prospective clinical study from a tertiary care unit. J Hum Reprod Sci. 2011;4:29-33.

Horcajadas JA, Pellicer A, Simon C. Wide genomic analysis ofhuman endometrial receptivity: new times, new opportunities. Hum Reprod Update. 2007;13:77-86.

Ng EH, Chan CC, Tang OS, Yeung WS, Ho PC. The role of endometrial and sub-endometrial blood flows measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during IVF treatment. Human Reproduction. 2006;21(1):164-70.

Demir R, Kayisli UA, Cayli S, Hupperzt B. Sequential steps during vasculogenesis and angiogenesis in the very early human placenta. Placenta. 2006;27:535-9.

Nardo LG. Vascular endothelial growth factor expression in the endometrium during the menstrual cycle, implantation window and early pregnancy. Curr Opin Obstetr Gynecol. 2005;17:419-23.

Sherer DM, Abulafia O. Angiogenesis during implantation, and placental and early embryonic development. Placenta. 2001;22:1-13.

Raine-Fenning NJ, Campbell BK, Kendall NR, Clewes JS, Johnson IR. Quantifying the changes in endometrial vascularity throughout the normal menstrual cycle with three-dimensionalpower Doppler angiography. Hum Reprod. 2004;19:330-8.

Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancyrates and outcome in an in vitro fertilization program. Fertil Steril. 1999;71:147-9.

Rabinowitz R, Laufer N, Lewin A, Navot D, Bar I, Margalioth EJ et al. The value of ultrasonographicendome-trial measurement in the prediction of pregnancy following in vitro fertilization. Fertil Steril. 1986;45:824-8.

Gonen Y, Casper RF, Jacobson W. and Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril.1989;52:446-50.

Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol. 2001;18:258-63.

Bakos O, Lundvist O, Bergh T. Transvaginal sonographic evaluation of endometrialgrowth and texture in spontaneous ovulatory cycles–a descriptive study. Hum Reprod.1993;8:799-806.

Sher G, Herbert C, Maassarani G, Jacobs MH. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing invitro fertilization and embryo transfer (IVF/ET). Hum Reprod.1996;6:232-7.

Serafini P, Batzofin J, Nelson, Olive D. Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. Fertil Steril. 1994;62:815-22.

El-Zenneni H, Moustafa R, Abdel-Hafeez M, El-Salally H, Abdel-Kader A, Elnaggar A. Assessment of uterine, sub-endometrial blood flows and endometrial gland vascular endothelial growth factor (EG-VEGF) in women with unexplained infertility. Middle East Fertil Soc J. 2015;20(2):119-26.

Jarvela IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G. Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound. Ultrasound Obstetr Gynecol. 2005;26:765-9.

Ng EHY, Chan CCW, Tang OS. The role of endometrial and subendometrial vascularity measured by three-dimensionalpower Doppler ultrasound in the prediction of pregnancy during frozen thawed embryo transfer cycles. Human Reprod. 2006;21:1612-7.

Rashidi BH, Sadeghi M, Jafarabadi M, Nejad EST. Relationships between pregnancy rates following in vitro fertilization orintracytoplasmic sperm injection and endometrial thickness andpattern. Eur J Obstetr Gynecol Reprod Biol. 2004;120:179-84.

Noyes N, Hampton BS, Berkeley A, Licciardi F, Grifo J, Krey L. Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis. Fertil Steril. 2001;76:92-7.

Dechaud H, Bessueille E, Bousquet PJ, Reyftmann L, HamamahS, Hedon B. Optimal timing of ultrasonographic and Doppler evaluation of uterine receptivity to implantation. Reprod Biomed Online. 2008;16:368-75.

Wang L, Qiao J, Li R, Zhen X, Liu Z. Role of endometrial bloodflow assessment with color Doppler energy in predicting pregnancy outcome of IVF-ET cycles. Reprod Biol Endocrinol. 2010;8:122.

Aghahoseini M, Tuba K, Marsousi V, Aleyasin A. Assessment of endometrial sub-endometrial blood flow detected by color Doppler sonography and uterine receptivity in infertile women. Acta Med Iran. 2008;46:461-6.

Nygren KG, Sullivan E, Zegers-Hochschild F, Mansour R, Ishihara O, Adamson GD, et al. International Committee for Monitoring Assisted Reproductive Technology (ICMART) world report: Assisted reproductive technology 2003 (1-17). Fertil Steril. 2011;95:2209-22.

Sardana D, Upadhyay AJ, Deepika K, Pranesh GT, Rao KA. Correlation of subendometrial-endometrial blood flow assessment by two-dimensional power Doppler with pregnancy outcome in frozen-thawed embryo transfer cycles. J Hum Reprod Sci. 2014;7(2):130-5.