Endometrial Length Research Articles

Rol de la ecografía ginecológica en la evaluación del desarrollo puberal en niñas y adolescentes

Introduction and objectivesTransabdominal ultrasonography (US) is the technique of choice for pelvis evaluation in pediatric population. The results of studies regarding US findings show a wide variation. The objectives of our study were: to estimate and correlate uterine and ovarian ultrasound measures (longitudinal diameter and volume) with chronological age (CA), breast Tanner stage (TS) and gynecological age (GA); to evaluate presence and size of follicles in patients according to their pubertal stage; and to determine the endometrial length in prepubertal and pubertal girls. Material and methodsUnicentric, observational, retrospective, analytical study, conducted between 2010 and 2019. Healthy girls between 8.0 and 16.0years, attended in the department of radiology were evaluated. Breast TS was evaluated and gynecological age was determined. Ultrasounds were performed by a pediatric diagnostic radiospecialist. Uterus length (UL) and ovarian length (OL) were measured; uterus and ovarian volume were calculated (UV and OV). Diameter of the largest follicle and endometrial thickness were measured. Results292 patients were analyzed, mean age was 12.5years (SD: 2.1). A significant correlation was observed between uterine and ovarian measurements with CA, TS and GA (P<.0001). A significant increase in UL and UV is described as the CA intervals increase, also in ovarian measurements. No significant differences in measurements were observed between TSI andII. An increase was evidenced at menarche. In 30.9% of pubertal patients and 11.8% of prepubertal patients showed ovarian follicles. The endometrium was not measurable in 88.24% of the pre-pubertal population and was always measurable in patients with TSIV andV. ConclusionsUterine and ovarian measurements increased with CA and ET (except ETI andII). The greatest increase occurred with menarche. Ovarian follicles and endometrium thickness less than or equal to 1mm were presented in prepubertal patients.

Accuracy of endometrial length measurement in predicting IVF/ICSI outcome.

This study aimed to evaluate if endometrial length (EL) affects the likelihood of a positive pregnancy test in individuals who had in vitro fertilization/intra cytoplasmic sperm injection (IVF/ICSI). Between December 2020 and June 2021, 100 women from those referred to the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, Al-Nahrain University, for IVF/ICSI were selected. These women were 20-40 years old with primary type sub-fertility and met the inclusion criteria. Controlled ovarian hyperstimulation (antagonist protocol), followed by transvaginal sonography (TVS), was used to measure the endometrial length (EL) from the internal ostium to the fundus on the day of ovum collection. Afterwards, the association between endometrial length and the outcome was examined. The data were analyzed using the Statistical Package for Social Sciences (SPSS). The data show an important link between EL and treatment success. Endometrial length of ≥39 mm was considered a good cut-off point for IVF/ICSI pregnancy rates with a sensitivity of 75%, a specificity of 68%, a positive predictive value of 57%, and a negative predictive value of 83, and area under the curve of 0.81. An endometrial length of 39 mm can be used as an appropriate cut-off point in IVF/ICSI to predict a greater pregnancy rate. Vaginal sonography could be used in the ART cycle to measure the endometrial length and thickness and to determine endometrial receptiveness.

The Importance of the Novel Postpartum Uterine Ultrasonographic Scale in Numerical Assessments of Uterine Involution Regarding Perinatal Maternal and Fetal Outcomes.

Background: Uterine involution assessments are critical for the prevention of postpartum hemorrhage. Various methods have been used worldwide. Methods: The PUUS (Postpartum Uterine Ultrasonographic Scale) method evaluates, by transabdominal ultrasonography, the length of the endometrium of the uterine cavity occupied by blood or debris, from grade 0 (no blood) to grade 4 (over three-quarters of the endometrial length occupied by blood/debris). A total of 131 consecutive patients admitted for delivery in the Elena Doamna Obstetrics and Gynecology University Hospital in Iasi, Romania, were prospectively evaluated using the PUUS method. The mean age was 27.72 years old, and they were examined during the first 24–48 h after vaginal delivery, or in the first 48–72 h after cesarean delivery. For patients with a PUUS grade greater than 1, re-examination was preformed daily in the following days, until the PUUS grade decreased to 1 or 0. Results: By standardizing uterine involution in a numerical fashion, we precisely demonstrate that uterine involution varied with the method of delivery (vaginal/cesarean) and with the number of vials of oxytocin received intrapartum, but not with the number of vials of ergometrine maleate received, and not with the origin of the parturient (rural/urban).

Postpartum Uterine Ultrasonographic Scale: a novel method to standardize the assessment of uterine postpartum involution.

Postpartum hemorrhage is a leading cause of maternal mortality. Various methods can be used to evaluate the postpartum uterine cavity volume. This work aims to introduce a simple method for uterine postpartum cavity volume evaluation, called Postpartum Uterine Ultrasonographic Scale (PUUS), which could be used routinely. In this prospective study, 131 consecutive Caucasian patients were evaluated by using the PUUS method. The mean age was 27.72 years (ranging from 15 to 42). Patients were examined in the same time intervals: within the first 24-48 hours after delivery in case of vaginal delivery, and within the first 48-72 hours, in case of cesarean delivery. Patients with PUUS grades 2, 3, or 4 were reexamined daily until the PUUS grade declined to 1 or 0. The PUUS method evaluated the length of the endometrium of the uterine cavity occupied by blood or debris, from grade 0 (no blood) to grade 4 (over three-quarters of the endometrial length occupied by blood/debris). The PUUS grade of uterine involution varied with the day of examination, gestation, and parity. In this article, a novel method of evaluating uterine postpartum involution titled PUUS is introduced. This method standardized uterine cavity involution in a numerical fashion. We hope that the PUUS scale could further be used to decrease the morbidity and mortality of women due to postpartum hemorrhage.

Effect of uterine dimensions on live birth rates after single embryo transfer in infertile women

Research questionDo uterine size parameters measured by baseline transvaginal ultrasound predict live birth after single embryo transfer (SET) of a high-quality blastocyst? DesignRetrospective cohort study including women undergoing their first SET between August 2010 and March 2014 at a large university hospital reproductive centre. The effects of baseline uterine dimensions on live birth rate (LBR) were analysed while controlling for confounding effects. ResultsA total of 437 nulliparous and 70 parous women were included. The nulliparous group had lower body mass index (BMI) (24.4 ± 5.1 versus 25.9 ± 4.5 kg/m2; P = 0.015) and a higher number of fibroids (0.4 ± 1.0 versus 0.2 ± 0.5; P = 0.005) than the parous group. While controlling for confounding effects, none of the uterine parameters appeared to be a significant predictor of LBR among nulliparous and parous women (P > 0.05 in all cases). A subsequent analysis of endometrial length was done, whereby the endometrial lengths were divided into quartiles (20.0–32.2 mm; 32.3–36.5 mm; 36.6–40.0 mm; 40.1–54.0 mm). After controlling for confounders, the shortest quartile in the nulliparous group had a significantly lower LBR (P = 0.02) than the other groups. Receiver operating characteristic curves suggested that endometrial cavity length and cervical length did not aid clinically. ConclusionUterine parameters do not have a clinically useful impact on LBR after SET of a blastocyst in infertile women. The use of baseline endometrial length to predict live birth is no better than chance, while cervical length only predicts failure to live birth.

Correlational Study of Endometrial Length and Thickness by 2D Ultrasound Parameter to the Endometrial Volume Obtained by 3D Ultrasound

Correlational Study of Endometrial Length and Thickness by 2D Ultrasound Parameter to the Endometrial Volume Obtained by 3D Ultrasound

Predictive Value of Endometrial Length Measurement by Transvaginal Ultrasound and IVF/ICSI Outcomes.

BackgroundThe purpose of this study to determine the relationship between endometrial length and positive preg- nancy test in patients who underwent assisted reproductive technology (ART).Materials and MethodsThis cross-sectional study included patients who were referred for in vitro fertilisation/in- tracytoplasmic sperm injection (IVF/ICSI) therapy from 2013 to 2016. All nulliparous women who met the inclusion criteria were between 20-38 years of age and presented for ultrasound measurements prior to fresh embryo transfer (ET). Endometrial length was measured by transvaginal ultrasound (TVS) with a Medison Accuvix device on the day of human chorionic gonadotropin (hCG) administration. The relationship between endometrial length and treatment success was assessed. The independent sample t test, receiver operating characteristic (ROC) curve and the area under the curve (AUC) index and chi-square test were used for data analysis. P values <0.05 were statistically significant.ResultsThere was a significant relationship between endometrial length (41.5%) and treatment success (P<0.05). The endometrial length of 41.5(mm) with a sensitivity of 66.7%, specificity of 50.6%, positive predictive value of 46.8%, negative predictive value of 69.4%, and efficiency of 56.62% can be used as a proper cut-off point with an AUC of 0.63.ConclusionThe value of 41.5(mm) for endometrial length can be used as a proper cut-off point for prediction of a higher ART success rate. We recommend TVS as the first step for assessment of uterine and endometrium receptivity in the ART cycle.

Length of the endometrial cavity as measured by uterine sounding and ultrasonography in women of different parities

BackgroundIn view of current controversies regarding the need for new, shorter intrauterine devices (IUDs) that would reduce expulsion rates in nulligravida, endometrial cavity length was measured in women of different parities using uterine sounding and ultrasonography. Study DesignA cross-sectional descriptive study was performed including 570 women of 17–52 years of age, 260 of whom were nulligravida and 310 parous. ResultsThe difference in mean length between measurements taken by uterine sounding and ultrasonography was 0.28 cm. Mean endometrial cavity length was 3.84±0.03 cm (mean±S.E.M.) in nulligravida and 4.25±0.03 cm in parous women according to uterine sounding (p<.001) and 3.70±0.03 cm and 3.84±0.03 cm, respectively, according to ultrasonography (p=.006). ConclusionsBy either technique, mean length of the endometrial cavity was >3.6 cm, the length of the most common IUDs, the TCu380A and the levonorgestrel-releasing intrauterine system. Therefore, the issue appears controversial for developing new, shorter IUDs, since current models fit most women, including nulligravida, albeit one third of the women of our sample showed endometrial length shorter than 3.2 cm.