An endometrial receptivity scoring system basing on the endometrial thickness, volume, echo, peristalsis, and blood flow evaluated by ultrasonography

Abstract

BackgroundEstablishing a successful pregnancy depends on the endometrium and the embryo. It is estimated that suboptimal endometrial receptivity account for one-third of implantation failures. Despite the indepth understanding of the processes associated with embryo-endometrial cross-talk, little progress has been achieved for diagnosis and treatments for suboptimal endometrial receptivity.MethodsThis retrospective study included women undergoing their first frozen-thawed embryo transfer (FET) cycles at our reproductive medicine center from March 2021 to August 2021. Transvaginal three-dimensional (3D) ultrasound was performed in the morning on the day of embryo transfer for all the thawed embryo transfer patients, to evaluate endometrial receptivity, including endometrial thickness, echogenicity, volume, movement and blood flow.ResultsA total number of 562 patients of FET with 315 pregnancies (56.0%) was analyzed. It was found that only the echo of the endometrial central line was different between the pregnant group and non-pregnant group. Other parameters, such as endometrial thickness, volume, endometrial peristalsis, or the endometrial blood flow were not statistically different between the two groups. Then, according to the relationship between the different groups and the clinical pregnancy rate, a score of 0 to 2 was respectively scored. The sum of the scores for the six items was the patient’s endometrial receptivity score. It showed that the clinical pregnancy rate increased as the endometrial receptivity score increased, and when the receptivity score reaches at least 5, the clinical pregnancy rate is significantly improved (63.7% versus 49.5%, P=0.001).ConclusionWe developed an endometrial receptivity scoring system and demonstrated its validity. It may aid clinicians in choosing the useful marker in clinical practice and for informing further research.

The Future Is Coming: Artificial Intelligence in the Treatment of Infertility Could Improve Assisted Reproduction Outcomes—The Value of Regulatory Frameworks

“…With regards to ovarian reserve follicular monitoring in the diagnosis of Polycystic Ovary Syndrome (PCOS), as well as prediction of oocyte quality and pregnancy outcomes, variables such as ovarian follicular diameter and volume, number of follicles, and ovarian stromal blood flow index were considered [ 48 ]. On the other hand, endometrial thickness and volume, endometrial morphology, and spiral arterial blood flow index are effective evaluation indicators [ 49 ]. There is a lot of ongoing research considering AI analysis of US images.…”

Does the SARS-CoV-2 mRNA vaccine damage the ovarian reserve?

“…[ 21 ] Endometrial thickness, endometrial morphology, subendometrial blood flow, uterine spiral artery blood flow, and menstrual patterns are also determinants of fertility that affect uterine receptivity. [ 22 ] In a comprehensive prospective study conducted by Wang et al, [ 23 ] it was shown that the Covid 19 mRNA vaccine causes a short-term prolongation of menstrual cycle times. For this reason, Wang et al concluded that the immune response after vaccination might temporarily affect the hypothalamic-pituitary-ovarin and endometrial parts.…”

Endometrial receptivity in women of advanced age: an underrated factor in infertility

“…Some studies suggest that endometrial patterns, such as triple-line configuration, patterns of a hyperechoic endometrium, and the presence of a central echogenic line detected by ultrasound as well as by the evaluation of endometrial blood flow, have more impact on the implantation potential as compared to endometrial thickness ( Gonen and Casper, 1990 ; Järvelä et al , 2005 ; Gingold et al , 2015 ; Navinchandra et al , 2016 ). Studies have also reported the combined approach of endometrial pattern together with thickness, and a scoring system for the prediction of pregnancy success during IVF ( Baruffi et al , 2002 ; Chen et al , 2010 ; Gingold et al , 2015 ; Khan et al , 2016 ; Navinchandra et al , 2016 ; Ugwu et al , 2022 ; Zhang et al , 2022 ). An IVF study reported that the triple-line endometrial pattern observed on the day of the administration of hCG was associated with an improved pregnancy rate compared to the homogenous, hyperechogenic, or intermediate endometrial pattern ( Gingold et al , 2015 ).…”