Predicting Clinical Pregnancy Rates in IVF-ET Using Transvaginal 3D Ultrasound and Serum Hormone Levels.

OBJECTIVE

To investigate the predictive value of transvaginal three-dimensional ultrasound combined with serum oestrogen and progesterone levels in enhancing the clinical pregnancy rate of in vitro fertilization-embryo transfer.

METHODS

The study was conducted at the Reproductive and Women-Children Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China, from September 2020 to March 2021, and comprised patients undergoing in vitro fertilization-embryo transfer with frozen-thawed embryo cycles. The day before embryo implantation, endometrial thickness and sub-endometrial blood flow parameters were measured using two-dimensional ultrasound and then converted to three-dimensional ultrasound mode to assess endometrial volume and sub-endometrial vascularisation parameters. Serum estradiol and progesterone levels were also measured on the day of transplantation. The subjects were categorised into pregnancy and non-pregnancy groups based on their outcomes. The correlation of two-dimensional and three-dimensional ultrasound parameters was compared alongside serum estradiol and progesterone levels with respect to clinical pregnancy outcomes. Data was analysed using SPSS 22.

RESULTS

Of the 100 women with mean age 32.8±8.3 years (range: 22-44 years), 56(56%) were in the clinical pregnancy group and 44(44%) were in the non-pregnancy group. There was no significant differences in endometrial thickness or two dimensional ultrasound sub-endometrial blood flow parameters between the groups (p>0.05). In contrast, endometrial volume and three-dimensional sub-endometrial vascularisation indices were significantly higher in the pregnancy group (p<0.05). Combining endometrial volume with serum estradiol levels yielded a predictive accuracy with area under the curve 0.735, sensitivity 77.3% and specificity 90.7%.

CONCLUSIONS

Transvaginal three-dimensional ultrasound-derived endometrial volume and sub-endometrial vascularisation parameters, combined with serum estradiol levels, could significantly improve the prediction of clinical pregnancy success in cases of in vitro fertilization-embryo transfer.