PREDICTIVE VALUE OF THE ECHOGRAPHIC CHARACTERISTICS OF ENDOMETRIUM ON IMPLANTATION RATE IN IN-VITRO FERTILIZATION IN UNSTIMULATED CYCLE
Abstract
Background. The purpose of this study was to determine whether endometrial features such as thickness, type and subendometrial movements observed by ultrasound on the day of embryo transfer in in vitro fertilisation (IVF) in natural cycles, can predict implantation outcome.
Methods. One hundred and eight natural IVF cycles in which the embryo transfer was performed were included in a prospective study. One hour prior to embryo transfer vaginal ultrasound examination was done to measure endometrial thickness, asses endometrial pattern and movements. The thickness and the type of endometrium were estimated in sagital plane of the uterus. Estimations of the direction of movements, amplitude and the amount of waves regarding the length of uterine cavity were performed. Women were divided into two groups: the first group consisted of those who conceived and the second of those who did not.
Results. The average age of women was 32.8 ± 4.07 years. Both groups were comparable in terms of age, estradiol level and average follicle diameter on the day of hCG application. Pregnancy rate on embryo transfer being 22.2% (24/108), and 84 women (77.8%) did not conceived. The thickness, type and endometrial movements were similar in both groups, therefore, not statistically significant (p > 0.05). Duration of menstrual cycles prior to hCG application in no concived group was shorter, statistically significant (p = 0.002).
Conclusions. On the basis owing to ultrasound characteristics such as subendometrial movements, thickness and pattern on the day of embryo transfer in the natural IVF/ICSI cycle have no predictive value of embryo implantation.
Downloads
References
Vlaisavljević V, Reljič M, Gavrić-Lovrec V, Kovačič B. Subendometrial contractility is not predictive for in vitro fertilisation (IVF) outcome. Ultrasound Obstet Gynecol 2000; 17: 239–44.
Fanchin R, Righini C, Francois O et al. Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilisation. Hum Reprod 1998; 13: 1968–74.
Gonen Y, Casper RF. Prediction of implantation by the sonographic appearance of endometrium during controlled ovarian stimulation for in vitro fertilisation. In Vitro Fertil Embryo Transf 1990; 7: 146–52.
Sher G, Dodge S, Massarani G et al. Management of suboptimal sonographic endometrial patterns in patients undergoing in vitro fertilisation and embryo transfer. Hum Reprod 1993; 8: 347–9.
Ueno J, Oehninger S, Brzyski RG et al. Ultrasonographic appearance of endometrium in natural and stimulated in-vitro fertilization cycles and its correlation with outcome. Hum Reprod 1991; 6: 901–4.
Khalifa G, Brzyski RG, Oehninger S, Acosta A, Mausher SJ. Sonographic appearance of endometrium: the predictive value for the outcome of invitro fertilisation in stimulated cycles. Hum Reprod 1992; 7: 677–80.
Eichler C, Krampl E, Reichel V et al. The relevance of endometrial thickness and echo patterns for the success of in vitro fertilization evaluated in 148 patients. J Assist Reprod Genet 1993; 19: 223–7.
Coulam CB, Bustillo M, Soenksen DM, Britten S. Ultrasonographic predictors of implantation after assisted reproduction. Fert Steril 1994; 2: 1004–10.
Olivera J, Baruffi R, Mauri A, Petersen C, Borges M, Franco J. Endometrial ultrasonography as predictor of pregnancy in in-vitro fertilisation programme after ovarian stimulation and gonadotropin relesing hormone and gonadotropins. Hum Reprod 1997; 12: 2515–8.
Gavrić V, Vlaisavljević V. Characteristic of endometrium in conceivers and nonconceivers after IVF. Hum Reprod 1993; 8: Suppl 1: 37–7.
Friedler S, Schenker JG, Herman A, Lewin A. The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Human Reprod Update 1996; 2: 324–35.
Kupešić S, Bekavac I, Bjelos D, Kurjak A. Assessment of endometrial receptivity by transvaginal color doppler and three-dimensional power doppler ultrasonography in patients undergoing in vitro fertilization procedures. J Ultrasound Med 2001; 20: 125–34.
Daya S, Gunby J, Hughes EG, Collins JA, Sagle MA, Young Lai EV. Natural cycles for in vitro fertilization: cost-effectiveness analysis and factors influencing outcome. Hum Reprod 1995; 10: 1719–24.
Tomaževič T, Geršak K, Meden-Vrtovec H et al. Clinical parameters to predict the success of IVF/ET in the natural cycles. Assisted Reprod 1999; 9: 149–56.
Al-Shawaf T, Yang D, Al-Magid Y et al. Ultrasonic monitoring during replacement of froze/thawed embryos in natural and hormone replacement cycles. Hum Reprod 1993; 8: 2068–74.
Vlaisavljević V, Kovačič B, Gavrić V. In vitro fertilisation program based on programmed cycles monitored by ultrasound only. Int J Gynecol Obstet 1992; 39: 227–31.
American Fertility Society, Society for Assisted Reproductive Technology. Assisted reproductive technology in the United State and Canada: 1992 results generated from American Fertility Society/Society for Assisted Reproductive Technology Registry. Fertil Steril 1994; 62: 1121–7.
Paulson RJ, Sauer MV, Lobo RA. Embryo implantation following human in vitro fertilisation: Importance of endometrial receptivity. Fertil Steril 1990; 53: 870–4.
Check JH, Lurie D, Dietterich C, Callan C, Baker A. Adverse effect of homogenous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in vitro fertilisation. Hum Reprod 1993; 8: 1293–6.
Forrest TS, Elyaderani MK, Muilenburg MI et al. Cyclic endometrial changes: US assessment with histologic correlation. Radiology 1988; 16: 233–40.
Ijland MM, Evers JLH, Dunselman GAJ, Vlovics L, Hoogland HJ. Relation between endometrial wavelike activity and fecundability in spontaneous cycles. Fertil Steril 1997; 67: 492–6.
Lyons EA, Taylor PJ, Zheng XH, Ballard G, Levi CS, Kredenster JV. Characterisation of subendometrial myometrial contractions throughout the menstrual cycle in normal fertile women. Fert Steril 1991; 55: 771–4.
Abramowicz JS, Archer DF. Uterine endometrial peristalsis-a transvaginal ultrasound study. Fertil Steril 1990; 54: 451–4.
The Author transfers to the Publisher (Zdravniški vestnik/Slovenian Medical Journal) all economic copyrights following form Article 22 of the Slovene Copyright and Related Rights Act (ZASP), including the right of reproduction, the right of distribution, the rental right, the right of public performance, the right of public transmission, the right of public communication by means of phonograms and videograms, the right of public presentation, the right of broadcasting, the right of rebroadcasting, the right of secondary broadcasting, the right of communication to the public, the right of transformation, the right of audiovisual adaptation and all other rights of the author according to ZASP.
The aforementioned rights are transferred non-exclusively, for an unlimited number of editions, for the term of the statutory
The Author can make use of his work himself or transfer subjective rights to others only after 3 months from date of first publishing in the journal Zdravniški vestnik/Slovenian Medical Journal.
The Publisher (Zdravniški vestnik/Slovenian Medical Journal) has the right to transfer the rights, acquired parties without explicit consent of the Author.
The Author consents that the Article be published under the Creative Commons BY-NC 4.0 (attribution-non-commercial) or comparable licence.
