Evaluation of Uterine Biophysical Profile in unexplained infertility and to assess its prognostic value in predicting pregnancy

Abstract

OBJECTIVE: To evaluate Uterine Biophysical Profile (UBP), an ultrasonographic uterine scoring system in women with unexplained infertility and to assess its prognostic value in predicting pregnancy.DESIGN: Prospective, observational study.MATERIALS AND METHODS: 30 women with unexplained infertility were evaluated for morphometric and Doppler characteristics of the endometrium including endometrial thickness, endometrial layering, endometrial blood flow in zone 3, pulsatility index of the uterine artery and myometrial ecogenicity, using transvaginal sonography and color Doppler, on day 2-3(baseline), day 11-13(periovulatory) and day 21-23(midluteal) of spontaneous cycle. Each parameter was scored using modified Uterine Scoring System for Reproduction. A total score for each phase was calculated by adding the values of individual variables. The cohort was followed up for 3 months. The UBP of women who subsequently conceived was compared to those who failed to conceive, to determine the applicability of the score to predict pregnancy.Table 1Periovulatory UBP: mean scores and significance levelsParameterConceived(n=13)Not conceived(n=17)PEndometrial thickness2.312.24NSEndometrial layering2.772.71NSEndometrial blood flow3.772.290.031Pulsatility index1.771.000.026Myometrial echogenicity1.922.00NSPeriovulatory total score12.5410.240.017NS = Not significant. Open table in a new tab Eleven out of 20 women (55%) with PTS of 11-15 conceived. Only 2/9 (22.2%) with PTS of 6-10 resulted in pregnancy while none with a score<5. On ROC analysis, PTS emerged as the most important variable to predict pregnancy (p<0.04, OR 1.48). PTS cut off of 11 or above was identified as the best predictor of pregnancy (sensitivity 84%, specificity 47%, positive predictive value 84.6%, negative predictive value 47.6%).CONCLUSIONS: In the present study, UBP demonstrated decreased endometrial receptivity especially poor endometrial blood flow in women with unexplained infertility who failed to conceive. Thus, UBP can prove to be a simple, rapid and non invasive tool to predict the uterine environment. OBJECTIVE: To evaluate Uterine Biophysical Profile (UBP), an ultrasonographic uterine scoring system in women with unexplained infertility and to assess its prognostic value in predicting pregnancy. DESIGN: Prospective, observational study. MATERIALS AND METHODS: 30 women with unexplained infertility were evaluated for morphometric and Doppler characteristics of the endometrium including endometrial thickness, endometrial layering, endometrial blood flow in zone 3, pulsatility index of the uterine artery and myometrial ecogenicity, using transvaginal sonography and color Doppler, on day 2-3(baseline), day 11-13(periovulatory) and day 21-23(midluteal) of spontaneous cycle. Each parameter was scored using modified Uterine Scoring System for Reproduction. A total score for each phase was calculated by adding the values of individual variables. The cohort was followed up for 3 months. The UBP of women who subsequently conceived was compared to those who failed to conceive, to determine the applicability of the score to predict pregnancy. NS = Not significant. Eleven out of 20 women (55%) with PTS of 11-15 conceived. Only 2/9 (22.2%) with PTS of 6-10 resulted in pregnancy while none with a score<5. On ROC analysis, PTS emerged as the most important variable to predict pregnancy (p<0.04, OR 1.48). PTS cut off of 11 or above was identified as the best predictor of pregnancy (sensitivity 84%, specificity 47%, positive predictive value 84.6%, negative predictive value 47.6%). CONCLUSIONS: In the present study, UBP demonstrated decreased endometrial receptivity especially poor endometrial blood flow in women with unexplained infertility who failed to conceive. Thus, UBP can prove to be a simple, rapid and non invasive tool to predict the uterine environment.