Sonographic prediction of successful embryonic implantation in in-vitro fertilization and embryo transfer cycle procedures, using a multi-parameter approach

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

“…Endometrial morphology can be assessed using ultrasonographic techniques to measure the thickness and study the echogenic pattern of the endometrium, both of which vary during each phase of the natural menstrual cycle in healthy fertile women ( Fitzgerald et al , 1994 ). Although there is no consensus about the minimum endometrial thickness that is favourable for the implantation of the embryo, clinical pregnancy has been achieved in women with endometrial thickness as low as 4 mm and as high as 16 mm ( Ugwu et al , 2022 ). On the other hand, an endometrial thickness of 7 mm has been reported to be a pre-requisite for implantation ( Tomic et al , 2020 ; Ugwu et al , 2022 ), followed by an increase in implantation rate when the endometrium increases from 8 to 11 mm, whereas when the endometrial thickness increases to >14 mm, it showed a dramatic decrease in implantation rate ( Eftekhar et al , 2019 ; Ugwu et al , 2022 ).…”

“…Although there is no consensus about the minimum endometrial thickness that is favourable for the implantation of the embryo, clinical pregnancy has been achieved in women with endometrial thickness as low as 4 mm and as high as 16 mm ( Ugwu et al , 2022 ). On the other hand, an endometrial thickness of 7 mm has been reported to be a pre-requisite for implantation ( Tomic et al , 2020 ; Ugwu et al , 2022 ), followed by an increase in implantation rate when the endometrium increases from 8 to 11 mm, whereas when the endometrial thickness increases to >14 mm, it showed a dramatic decrease in implantation rate ( Eftekhar et al , 2019 ; Ugwu et al , 2022 ). The assessment of endometrial thickness in different age groups of healthy women revealed that the endometrium was significantly thicker during the mid-secretory phase compared to ovulation day in all the age groups.…”

“…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 ).…”

“…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 ). However, as for endometrial thickness, there are conflicting conclusions even on the correlation of endometrial pattern with pregnancy rate ( Gonen and Casper, 1990 ; Check et al , 1993b ; Järvelä et al , 2005 ; Potlog-Nahari et al , 2005 ; Rashidi et al , 2005 ; Mercé et al , 2008 ; Ugwu et al , 2022 ), without the information on age-related shift. The endometrial thickness and pattern can be used as prognostic indicators for endometrial receptivity; however, these features have not been well accepted as sole predictive markers for successful implantation ( Navinchandra et al , 2016 ).…”