Utility of endometrial multi-vessel blood flow ultrasound parameters in predicting pregnancy outcomes.

OBJECTIVES

To evaluate the endometrium using multi-vessel blood flow ultrasound parameters and explore their potential utility in predicting pregnancy outcomes.

METHODS

A total of 205 women were included in the study. Transvaginal three-dimensional ultrasound was used to evaluate luteal phase endometrial thickness, volume, and three-dimensional power Doppler blood flow parameters of the endometrium (vascularization index [VI], flow index [FI], and vascularization flow index [VFI]), as well as the endometrial microvascular vascularization index (VIMV). Additionally, the systolic/diastolic ratio (S/D), pulsatility index (PI), and resistance index (RI) of the bilateral uterine arteries were measured. Based on pregnant outcomes, participants were divided into two groups: a clinical pregnancy group and a non-pregnancy group, and ultrasound parameters were compared between these groups.

RESULTS

Women in the clinical pregnancy group showed significantly higher levels of endometrial FI, VI, VFI, and VIMV compared to those in the non-pregnancy group (p<0.05). Conversely, the S/D, PI, RI, and mean levels of bilateral uterine arteries were significantly lower in the pregnancy group than in the non-pregnancy group (p<0.05). VIMV (area under the ROC curve [AUC] 0.869; sensitivity 92.2 %, specificity 68.8 %), VFI (AUC 0.761; sensitivity 96.9 %, specificity 53.9 %), FI (AUC 0.707; sensitivity 79.7 %, specificity 46.1 %), and VI (AUC 0.637; sensitivity 90.6 %, specificity 51.8 %) all showed a significant strong positive correlation with endometrial thickness (r>0, p<0.05), indicating their role in predicting pregnancy.

CONCLUSIONS

Multi-vessel blood flow parameters reflect the endometrial blood perfusion state and are closely associated with the likelihood of achieving a successful pregnancy.