Uterine contractility and elastography as prognostic factors for pregnancy after intrauterine insemination

Swierkowski-Blanchard, Nelly; Boitrelle, Florence; Alter, Laura; Selva, J.; Quibel, Thibaud; Torre, Antoine

doi:10.1016/j.fertnstert.2017.02.002

Cited by 23 publications

(19 citation statements)

References 42 publications

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“…Elastography, the measure of tissue deformation on ultrasound assessment, is a promising surrogate for uterine peristalsis with a single study demonstrating an area under the curve (AUC) of 0.74 for prediction of clinical pregnancy. 43 The use of speckle-tracking ultrasound has also emerged as a potential objective tool requiring further investigation and validation. 44…”

Section: Measurement Of Uterine Peristalsismentioning

confidence: 99%

Impairment of Uterine Contractility Is Associated with Unexplained Infertility

Hunt

Abdallah

et al. 2020

Semin Reprod Med

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The uterine junctional zone represents the juncture between endometrium and myometrium. The junctional zone is hormonally dependent and displays continuous peristaltic activity throughout the menstrual cycle in the nonpregnant state which is concerned with sperm transport and embryo implantation. Peristalsis may be observed using various invasive and noninvasive modalities, of which ultrasound is the most readily applied in the clinical setting. Women with pelvic pathology display alterations in uterine peristalsis which may contribute to infertility. Characterization of peristalsis in infertility subgroups, the development of a subjective peristalsis tool, and the application of potential therapeutics to an assisted reproductive treatment setting are the subject of ongoing investigation. Meta-analysis indicates a potential role for oxytocin antagonist in the improvement of fertility treatments.

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Section: Measurement Of Uterine Peristalsismentioning

confidence: 99%

Impairment of Uterine Contractility Is Associated with Unexplained Infertility

Hunt

Abdallah

et al. 2020

Semin Reprod Med

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“…This also may explain the wide variation seen in the aforementioned studies, which only report a single measurement in time. Proposed objective and higher fidelity techniques such electrohystography, elastography, and speckle tracking to measure tissue strain may have the potential to significantly improve this variability and further investigation is necessary (Mischi and Schoot, 2015;Swierkowski-Blanchard et al, 2017;Sammali et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Assessing Peristalsis at the Endometrial–Myometrial Junctional Zone: A Reproducible Ultrasound Technique?

Hunt

Low

Dunn

et al. 2020

FandR

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Background:Uterine peristalsis occurs in the endometrial–myometrial junctional zone. It is involved in sperm transport and embryo implantation in spontaneous and in vitro fertilization (IVF) cycles. We investigated the reproducibility of transvaginal assessment of peristalsis and endometrial combined thickness (ECT) as a surrogate marker for contraction frequency and directionality. Methods:We studied 74 women undergoing IVF between 2015 and 2018. On day 9 of stimulation, participants had a transvaginal ultrasound to assess follicular development and ECT. Women proceeding to fresh embryo transfer had an ultrasound preprocedure. A videoclip was analyzed for frequency (total contractions per minute) and directionality of contractions (cervical to fundal [CF] and fundal to cervical [FC]). Anonymized images were reviewed on three separate occasions by a single observer. Intraclass correlation (ICC with 95% CI) and Bland–Altman plots were constructed to assess intraobserver agreement. Secondary analysis was performed to assess peristalsis with ECT and pregnancy rates. Results:Between the first and second observations, there was suboptimal correlation between visual assessment of contraction frequency and directionality (ICC–total 0.67 (0.43–0.80) p < 0.001, ICC–CF 0.62 (0.35–0.78), p < 0.001, ICC–FC 0.74 (0.55–0.85), p < 0.001. Correlation for both frequency and directionality significantly improved between second and third viewing (ICC–total 0.97 (0.95–0.98), p < 0.001, ICC–CF 0.84 (0.73–0.91), p < 0.001, ICC–FC 0.89 (0.81–0.94), p < 0.001). Good agreement was seen on Bland–Altman plots with narrower limits of agreement on second and third viewing. Median ECT was 10 mm (interquartile range [IQR] 8–12 mm). Women with ECT [Formula: see text] 10 mm versus <10 mm demonstrated more contractions per minute (2.2 ± 0.7 vs. 1.7± 0.6, p = 0.02). The clinical and ongoing pregnancy rates were 33% (20/60) and 22% (13/60), respectively. There was no association between pregnancy and peristalsis frequency or directionality. Conclusion:Uterine peristalsis is a reproducible observation displaying a learning curve to achieve excellent agreement. Endometrial thickness [Formula: see text]10 mm was associated with increased contraction frequency. There was no association between contraction frequency and/or directionality and clinical pregnancy rates.

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“…Swierkowski-Blanchard conducted an observational pilot study to determine the impact of the frequency and intensity of uterine contractions (UCs) at the time of IUI on subsequent fertility [47]. One hundred volunteer women scheduled for IUI between April 2011 and July 2013, in whom UCs were assessed during the ultrasound before IUI was included.…”

Section: The Future Is Nowmentioning

confidence: 99%

“…A low frequency and high intensity of UCs at the day of IUI appear associated with a higher pregnancy rate. Elastography provides a promising innovative tool for IUI monitoring [47].…”

Section: The Future Is Nowmentioning

confidence: 99%