Continuous Endometrial Volumetric Analysis for Endometrial Receptivity Assessment on Assisted Reproductive Technology Cycles

Abstract Background: Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. In order to assess endometrial receptivity in Assisted Reproductive Technology (ART) cycles continuous evaluation of endometrial biophysical markers may have a predictive value on a positive outcome.Design: Serial 3D transvaginal ultrasound performed in women on ART cycle to evaluate a pattern that better predicts implantation rates. 169 subjects on a prospective case control study were assessed. Endometrial pattern, endometrial thickness, endometrial volume and adjusted endometrial volume (ratio between endometrial volume and uterine volume) was performed to all subjects on a continuous process from baseline (prior to ovarian controlled stimulation), day 6, 8 and 10 of controlled ovarian stimulation, trigger day with human chorionic gonadotropin hormone (hCG) and at embryo transfer day.Results: No statistical difference was noted between the two groups in terms of demographics and ART procedures and scores. Endometrium morphology also didn’t show any difference between the two groups. Endometrial volume and adjusted endometrial volume was significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation.Conclusions: Continuous serial 3D endometrial volume and adjusted endometrial volumes may be a useful tool for clinicians in predicting endometrial receptivity enhancing elective embryo transfers in fresh ART cycle, and thus providing a non-invasive continuous technique for endometrial receptivity assessment that reflects endometrial changes during ART procedures.