P-526 Modified Applebaum uterine scoring system to predict uterine receptivity in frozen embryo transfer(FET) cycles

Abstract

Abstract Study question To evaluate modified Applebaum uterine scoring system in predicting the uterine receptivity and clinical pregnancy rate? Summary answer The modified version of Applebaum uterine scoring system has sensitivity of 0.9411 and specificity of 0.5869 in predicting the uterine receptivity in embryo transfer cycle. What is known already The endometrial receptivity have been accepted to be major limiting factors in the establishment of pregnancy. Different techniques have been developed to evaluate endometrial receptivity, such as endometrial receptivity array or histological dating. The advantage of Ultrasound is it’s non-invasiveness, repeatability, real time monitoring and predictability. Study design, size, duration It is a prospective observational study. Study group comprises of 200 female with primary infertility over a period of 6 month. Participants/materials, setting, methods Exclusion criteria was patients associated with male sub-fertility or having uterine anomalies. The study was conducted at D.Y.Patil fertility centre, unit of Bloom IVF. All the patients were given uterine scoring before FET based on Endometrial thickness, morphology, vascularisation, myometrial echogenicity, uterine artery PI and EDF, myometrial blood flow. Main results and the role of chance The overall pregnancy rate was 54%. A perfect score of 20 was associated with 97.4% pregnancy rate. Scores of 17 to 19 was associated with the pregnancy rate of 85.4% and scores of 14 to 16 was associated with the pregnancy rate of 28.6%. Score less than 13 is not associated with any pregnancy. The Modified Applebaum scoring system showed the sensitivity of 0.9411 and specificity of 0.5869 in predicting the outcome of the cycle. On an individual basis, endometrial morphology, end diastolic blood flow(EDF) and Pulsatility index(PI) of uterine artery and myometrial blood flow were found to be significant for a pregnancy on the basis of Z score and p value of < 0.01 Limitations, reasons for caution As there were no case of secondary infertility, Grade III/IV endometriosis, endocrine disorder and uterine anomalies. The scoring system might not replicate the same results. Wider implications of the findings As the sensitivity and specificity of this uterine scoring system is quite good. It could be a good tool in assessing endometrium before embryo transfer. Trial registration number Not applicable