Assessment of uterine receptivity by endometrial and sub-endometrial blood flow using SlowflowHD in hormone prepared frozen embryo transfer cycles: a pilot study

Sadek, Seifeldin; Matitashvili, Tamar; Kovac, Alessandra; Ramadan, Hadi; Stadtmauer, Laurel

doi:10.1007/s10815-022-02454-8

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…Moreover, if a patient underwent 3 consecutive ultrasound examinations in the study and color artifacts were present in any 1 examination, that patient was excluded. Our findings on 3D-PD imaging of blood flow changes to predict IVF outcomes were partially identical to those of a recent study ( 12 ). In our study, changes in endometrial blood flow were observed twice before transplantation, but neither change was predictive of the IVF outcome.…”

Section: Discussionsupporting

confidence: 90%

“…Ultrasound evaluation of ER includes measurements of endometrial thickness (EMT), endometrial patterns, endometrial volume (EV), and endometrial blood flow ( 9 , 10 ). However, the results of studies using a single ultrasound evaluation of ER are inconsistent ( 11 , 12 ). For example, EMT is widely regarded as a predictor of ER, and a thin EMT is associated with a low in vitro fertilization (IVF) success rate ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Using 2D/3D ultrasound observation of endometrial thickness, endometrial volume, and blood flow changes to predict the outcome of frozen embryo transfer cycles: a prospective study

Liu¹,

Yue²,

Wang³

et al. 2023

Quant Imaging Med Surg

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Background: Endometrial thickness (EMT) and blood flow are commonly used indicators of endometrial receptivity. However, the results of single ultrasound examination studies differ. Therefore, we used 3-dimensional (3D) ultrasound to study the influence of changes in EMT, endometrial volume, and endometrial blood flow on frozen embryo transfer cycles.Methods: This was a prospective cross-sectional study. Women who underwent in vitro fertilization (IVF) at Dalian Women and Children's Medical Group and met the inclusion criteria were enrolled between September 2020 and July 2021. Ultrasound examinations were performed in patients who underwent frozen embryo transfer cycles on the day of progesterone administration, the third day after progesterone administration, and the day of embryo transplantation. Two-dimensional ultrasound was used to record EMT, 3D ultrasound was used to record endometrial volume, and 3D power Doppler ultrasound imaging was used to record the following endometrial blood flow parameters: vascular index, flow index, and vascular flow index. Changes in the 3 inspections of the EMT, volume, vascular index, flow index, and vascular flow index and 2 inspections of estrogen levels were categorized as "declining" or "nondeclining". The relationship between changes in a certain indicator and the IVF outcome was analyzed by univariate analysis and multifactorial stepwise logistic regression.Results: In total, 133 patients were enrolled in this study, 48 were excluded, and 85 were included in the statistical analysis. Among these 85 patients, 61 were pregnant (71%), 47 had a clinical pregnancy (55%), and 39 had an ongoing pregnancy (45%). The results showed that if the first change in endometrial volume was nondeclining, the outcomes of clinical and ongoing pregnancies were more likely to be unfavorable (P=0.03, P=0.01). Additionally, if the second change in endometrial volume on the day of embryo transplantation was nondeclining, the outcome of an ongoing pregnancy was more likely to be favorable (P=0.03). Conclusions:The changes in endometrial volume was a factor helpful in predicting the IVF outcome, whereas the changes in EMT and endometrial blood flow analyses were not helpful in predicting IVF outcome.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Using 2D/3D ultrasound observation of endometrial thickness, endometrial volume, and blood flow changes to predict the outcome of frozen embryo transfer cycles: a prospective study

Liu¹,

Yue²,

Wang³

et al. 2023

Quant Imaging Med Surg

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“…But there are also dissenters. Sadek et al (2022) found pregnancy and live births were associated with a lower mean percentage drop in blood flow from day 15 to the day of transfer and elevated RI and S/D ratio on transfer day. Sardana said ( Sardana et al, 2014 ) that the presence of endometrial blood flow was highly correlated with the cycle outcome in HRT-FET cycles, and the embryo implantation rate and clinical pregnancy rate of the endometrial blood flow signal group were significantly higher than those with the absented blood flow group in the subendometrial-endometrial region.…”

Section: Discussionmentioning

confidence: 84%

“…Ultrasound-measured endometrial blood flow is one of the important evaluation indicators of endometrial morphology. There have been many studies about it ( Son et al, 2014 ; Koo et al, 2018 ; Sadek et al, 2022 ), but ultrasound indicators which predicted of the outcomes of ART existed for endometrial blood flow are controversial. The relationship between endometrial blood flow and pregnancy outcome is even more uncertain.…”

Section: Introductionmentioning

confidence: 99%

Association between endometrial blood and clinical outcome in frozen single blastocyst transfer cycles

Zhang

Wang

et al. 2023

Front. Physiol.

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Background: The success of embryo transfer cycle depends mainly on the quality of embryo and endometrial receptivity. Ultrasound examination is still the most widely used non-invasive evaluation method for its advantages of convenience, non-invasiveness and repeatability. Ultrasound-measured endometrial blood flow is one of the important evaluation indicators of morphology.Aims: To investigate the effect of the number of endometrial blood flow branches on pregnancy outcome of frozen-thawed embryo transfer cycles which have undergoing hormone replacement therapy (HRT-FET).Material and methods: A retrospective cohort study was performed looking at a total of 1390 HRT-FET cycles from our reproductive medicine center between January 2017 to December 2021, which transferred one blastocyst frozen on day 5 with good quality in morphology. Associations between endometrial blood flow branches and pregnancy outcomes were evaluated with multivariable linear regression analysis.Results: The number of endometrial blood flow branches was independently associated with clinical pregnancy (OR 1.10; 95% CI 1.02–1.20). After adjusting for potential confounders, the effect size (odds ratio) was 1.09 (95% CI 1.00–1.19), and the results showed that the clinical pregnancy rate and live birth rate of T2 and T3 groups were significantly higher than those in group T1 (p < 0.05). Subgroup analysis showed that a consistent association between the endometrial blood flow branches and clinical pregnancy in all subgroups.Conclusion: Our study provided evidence for the influence of endometrial blood flow on pregnancy outcomes. There may be an independent association between the number of endometrial blood flow branches and pregnancy outcomes in frozen-thawed single blastocyst transfer cycles.

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“…This study had the advantage of being the first prospective cohort study to use PD-US to detect endometrial receptive ultrasound indicators at two time points after HRT-FET. Due to the inconsistent Doppler signal waveforms of these small spiral vessels, predicting pregnancy using the spiral artery Doppler flow index is highly controversial [16][17][18]; thus, our study did not measure the subendometrial vascularization flow index but instead chose a more intuitive indicator for assessing blood perfusion. Previous studies have reported that blood flow to the endometrium affects pregnancy outcomes after freeze-thawed embryo transfer; however, the detection methods needed to be more consistent.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy prediction via ultrasound-detected endometrial blood for hormone replacement therapy-frozen embryo transfer: a prospective observational study

Ke,

Liang,

Lin

et al. 2023

Reprod Biol Endocrinol

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Background This study aimed to assess the predictive value of endometrial blood flow branches on pregnancy outcomes after hormone replacement therapy-frozen embryo transfer (HRT-FET). Methods This prospective observational study involved 292 reproductive-aged women who underwent endometrial receptivity assessment in a tertiary care academic medical center in southwest China using power Doppler ultrasonography during HRT-FET. Three-dimensional power Doppler ultrasound was performed on the day of endometrial transformation and the day before embryo transfer. The endometrial blood flow branches of the endometrial and subendometrial regions were compared in the non-pregnant and pregnant groups at the two time points mentioned above. Results The endometrial blood flow branches were higher in pregnant patients than in non-pregnant patients on the day of endometrial transformation (P = 0.009) and the day before embryo transfer (P = 0.001). Changes in endometrial blood flow pattern and endometrial blood flow branches at the two time points did not differ among the pregnancy outcome samples. After adjusting for age, antral follicles, and embryos transferred, the endometrial blood flow branches on the day before embryo transfer was the independent factor influencing the chance of clinical pregnancy, with an odds ratio of 3.001 (95% confidence interval: 1.448 − 6.219, P = 0.003). Conclusions Endometrial blood flow perfusion during the peri-transplantation period of the HRT-FET cycle is a good indicator of pregnancy outcomes, suggesting that valuation of endometrial branches via power Doppler ultrasound is a simple and effective approach for achieving indicator measurements.

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Assessment of uterine receptivity by endometrial and sub-endometrial blood flow using SlowflowHD in hormone prepared frozen embryo transfer cycles: a pilot study

Cited by 7 publications

References 24 publications

Using 2D/3D ultrasound observation of endometrial thickness, endometrial volume, and blood flow changes to predict the outcome of frozen embryo transfer cycles: a prospective study

Using 2D/3D ultrasound observation of endometrial thickness, endometrial volume, and blood flow changes to predict the outcome of frozen embryo transfer cycles: a prospective study

Association between endometrial blood and clinical outcome in frozen single blastocyst transfer cycles

Pregnancy prediction via ultrasound-detected endometrial blood for hormone replacement therapy-frozen embryo transfer: a prospective observational study

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