Publication:

A study of correlation of endometrial morphology and subendometrial vascularity with pregnancy rate in fresh and frozen embryo transfer cycles

Background Aim of the study was to evaluate the correlation of endometrial morphology and sub endometrial vascularity with pregnancy rate in fresh and frozen embryo transfer cycles.

Methods Prospective, non-randomized observational study done on 76 women undergoing in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) treatment at a tertiary health care center. Woman with tubal factor, male factor and unexplained infertility were included in the study. Parameters like endometrial thickness, endometrial pattern, endometrial blood flow were correlated to clinical outcomes such as implantation and clinical pregnancy rates. Independent two-tailed t-test and chi-square test was used as a part of statistical analysis.

Results There is no significant difference in distribution of mean age, mean duration of infertility, cause of infertility, mean basal follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P4), anti-Mullerian hormone (AMH), total gonadotropin dose, median E2 (on day of trigger), median P4 (on day of trigger), number of embryos transferred and endometrial thickness between group of cases with positive and negative pregnancy in our study group. Whereas body mass index (BMI), blastocyst quality of embryo transferred, triple-line pattern of endometrium and endometrial blood flow reaching zone 4 were found to be significant in the study group.

Conclusions A combination of endometrial thickness and Doppler analysis of endometrial blood flow was a simple and effective tool to improve pregnancy rates in hormone replacement treatment-frozen embryo transfer (HRT-FET) cycles and should be incorporated into routine clinical practice. In addition, this can help us reduce the number of embryos to be transferred and hence, the multiple pregnancies and the associated complications.