Different Methods of Evaluating the Endometrium before Embryo Transfer. Is it Better than Measuring the Endometrial Thickness?

INTRODUCTION: Transvaginal ultrasound measurement of endometrial thickness is widely used as an alternative to invasive techniques like endometrial biopsy for assessment of receptivity. Recent studies have focused on measurement of sub-endometrial contractility, and computer-enhanced 3-D modeling scoring of the endometrium.

AIM: Comparing pregnancy outcome of patients who performed the 3-D scoring or the sub-endometrial measurement prior to the embryo transfer with patients who did not.

Methods and MATERIALS: Single center retrospective cohort study of 635 freeze/thaw cycles of blastocysts vitrified on day 5 and transferred between January 2016 and August 2016.

Results: First we compared the patients who performed 3-D scoring with the control group and found clinical pregnancy rate (42% vs. 44.3, p=NS) and ongoing pregnancy rate (31.7% vs. 33.9% p=NS) were comparable between the two groups. Second we compared the patients who performed the sub-endometrial wave measurements with the control group and found similar findings, clinical pregnancy rate (38.2% vs. 44.3, p=NS) and ongoing pregnancy rate (30.8% vs. 33.9% p=NS) were comparable between the two groups. Then we performed regression analysis to examine the independent contribution of different variables to the ongoing pregnancy rates; both the 3-D and the wave count procedures were not found to have any influence on the ongoing pregnancy rates.

Conclusions: New ultrasonic methods of evaluating the endometrium prior to ET have been proposed during the last years, these methods in our hands have not been shown to improve the pregnancy rates compared to the original method of assessing the endometrium by measuring the endometrial thickness.