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Research Paper | Obstetrics and Gynecology | India | Volume 12 Issue 12, December 2023 | Rating: 5.4 / 10
Enhancing IVF Success: The Role of Endometrial Receptivity and Uterine Scoring in Predicting Pregnancy Outcomes
Dr. Archana S [6] | Dr. K M Kundavi | Dr. Geetha V [4] | Dr. Rashmi [28] | Dr. Nithya Naaram [2]
Abstract: Introduction: Infertility is defined as the failure to conceive after 12 months or more of regular unprotected intercourse. Infertility can create divisive among the affected couples, as well as among their relatives and friends. The achievement of a successful pregnancy hinges on a multifaceted process, requiring both a high - quality embryo and a receptive endometrium. Endometrial receptivity specifically refers to the endometrium's capability to effectively engage with the embryo, providing nourishment and sustaining its viability. It has become absolute necessity to evaluate uterus and endometrium prior to embryo transfer, so that optimum results are obtained in favourable uteri. Materials and Methods: In this prospective pilot study, 65 women underwent frozen - thawed embryo transfer (FET) cycles at our reproductive medicine centre from March to October 2023. Uterine receptivity was assessed by analysing ultrasonographic and Doppler parameters on the day of initiating progesterone. The assessment utilized the Applebaum Uterine Scoring System, encompassing various parameters such as endometrial thickness, morphology, endometrial blood flow within zone 3, myometrial echogenicity, uterine artery pulsatility index (PI), end - diastolic blood flow, presence of endometrial motion, and myometrial blood flow. To add on, we also analysed the endometrial volume using the 3D scan and the direction of endometrial motion as ultrasonic markers. Results: Out of total 65 subfertility patients for embryo transfer 20 conceived, which gives 30.8% pregnancy rate. No patients had a perfect score of 20. Patients with score of 17 - 19 had pregnancy rate of 82.4 %. Endometrial thickness of 10 - 14mm gave optimum result of 55.6 %. Pulsatility index with 2.2 - 2.49 was associated with pregnancy rate of 40.7%. No significant association was found between Endometrial Volume and pregnancy rate. Conclusion: Applebaum?s USSR scoring is a simple and noninvasive method for prediction of pregnancy rate in ICSI and embryo transfer cycle. Endometrial receptivity including thickness and vascularity are predominant in predicting outcome of pregnancy.
Keywords: Endometrial receptivity, applebaum uterine scoring system, ICSI, embryo transfer
Edition: Volume 12 Issue 12, December 2023,
Pages: 1319 - 1325