Ultrasonography and Doppler Study to Predict Uterine Receptivity in Infertile Patients Undergoing Embryo Transfer

Abstract

To detect whether ultrasonographic parameters and Doppler analysis of uterine blood flow can be of value in the prediction of endometrial receptivity in infertile female patients undergoing embryo transfer. In this study, a total of 200 women with primary infertility undergoing embryo transfer were analyzed. Transvaginal ultrasonography was done on the 10th day of the menstrual cycle. To assess the uterine receptivity, we analyzed all the ultrasonographic and Doppler parameters. The slightly modified version of Applebaum Uterine Scoring System was used. This uterine scoring system included all the following parameters: endometrial thickness, endometrial morphology, endometrial blood flow within zone 3, myometrial echogenecity, uterine artery pulsatility index (PI), end diastolic blood flow, and myometrial blood flow internal to the arcuate vessels seen on gray-scale examination. The pregnancy rates were higher in women with thick, distinct five-line endometrium and multifocal endometrial vascularity within zone 3. Absent endometrial flow, despite highest values for the other parameters, was associated with no conception. In our study, no pregnancy occurred with uterine PI values of more than 2.8. Absence or reversal of end diastolic blood flow was associated with no conception. A maximum score of 20 was associated with the pregnancy rate of 97.4%, whereas scores of 13 or less resulted in no pregnancies. Uterine scoring system will help to perform embryo transfers in only favorable uteri and postpone or cancel those cycles in which poor uterine score is demonstrated.