Journal of Assisted Reproduction and Genetics

, Volume 36, Issue 1, pp 139–143 | Cite as

Sub-endometrial contractility or computer-enhanced 3-D modeling scoring of the endometrium before embryo transfer: are they better than measuring endometrial thickness?

  • Nivin Samara
  • Robert F. Casper
  • Rawad Bassil
  • Mahvash Shere
  • Eran Barzilay
  • Raoul Orvieto
  • Jigal HaasEmail author
Assisted Reproduction Technologies



Recent studies have focused on transvaginal ultrasound measurement (TVUS) of sub-endometrial contractility and computer-enhanced 3-D modeling scoring of the endometrium prior to embryo transfer (ET).The aim of this study was to compare pregnancy outcome of patients who performed the 3-D scoring or the sub-endometrial measurement prior to the ET with patients that did not perform those procedures.


A single center retrospective cohort study of 635 freeze/thaw cycles of blastocysts vitrified on day 5 and transferred between January 2016 and August 2016.


We compared the patients who performed 3-D scoring with the control group and found comparable patients’ characteristics, clinical pregnancy rates (42% vs. 44.3, p = NS, respectively), and ongoing pregnancy rates (31.7% vs. 33.9%, p = NS).We then compared the patients who performed the sub-endometrial wave measurements with the control group and found similar findings. The clinical pregnancy rate (38.2% vs. 44.3, p = NS, respectively) and the ongoing pregnancy rate (30.8% vs. 33.9%) were comparable between the two groups. We performed a 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.


Although new ultrasonic methods of evaluating the endometrium have been proposed during the last years, these methods have not been shown to improve the pregnancy rates compared to the original method of assessing the endometrium by measuring the endometrial thickness.


Sub-endometrial waves 3-D endometrial scoring FET 


Compliance with ethical standards

Ethics statement

The study was approved by the Research Ethics Board at Mount Sinai Hospital in Toronto.


  1. 1.
    Shapiro BS, Daneshmand ST, Restrepo H, Garner FC, Aguirre M, Hudson C. Matched-cohort comparison of single-embryo transfers in fresh and frozen-thawed embryo transfer cycles. Fertil Steril. 2013;99:389–92.CrossRefGoogle Scholar
  2. 2.
    Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C. Clinical rationale for cryopreservation of entire embryo cohorts in lieu of fresh transfer. Fertil Steril. 2014;102:3–9.CrossRefGoogle Scholar
  3. 3.
    Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C, Thomas S. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen-thawed embryo transfer in normal responders. Fertil Steril. 2011;96:344–8.CrossRefGoogle Scholar
  4. 4.
    Ozgur K, Berkkanoglu M, Bulut H, Humaidan P, Coetzee K. Perinatal outcomes after fresh versus vitrified-warmed blastocyst transfer: retrospective analysis. Fertil Steril. 2015;104:899–907 e3.CrossRefGoogle Scholar
  5. 5.
    Bergh PA, Navot D. The impact of embryonic development and endometrial maturity on the timing of implantation. Fertil Steril. 1992;58:537–42.CrossRefGoogle Scholar
  6. 6.
    Isaacs JD Jr, Wells CS, Williams DB, Odem RR, Gast MJ, Strickler RC. Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone. Fertil Steril. 1996;65:262–6.CrossRefGoogle Scholar
  7. 7.
    Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril. 1999;71:147–9.CrossRefGoogle Scholar
  8. 8.
    Wu Y, Gao X, Lu X, Xi J, Jiang S, Sun Y, et al. Endometrial thickness affects the outcome of in vitro fertilization and embryo transfer in normal responders after GnRH antagonist administration. Reprod Biol Endocrinol. 2014;12:96.CrossRefGoogle Scholar
  9. 9.
    Kasius A, Smit JG, Torrance HL, Eijkemans MJ, Mol BW, Opmeer BC, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod Update. 2014;20:530–41.CrossRefGoogle Scholar
  10. 10.
    Fanchin R, Righini C, Olivennes F, Taylor S, de Ziegler D, Frydman R. Uterine contractions at the time of embryo transfer alter pregnancy rates after in-vitro fertilization. Hum Reprod. 1998;13:1968–74.CrossRefGoogle Scholar
  11. 11.
    Fanchin R, Ayoubi JM, Olivennes F, Righini C, de Ziegler D, Frydman R. Hormonal influence on the uterine contractility during ovarian stimulation. Hum Reprod. 2000;15(Suppl 1):90–100.CrossRefGoogle Scholar
  12. 12.
    Fanchin R, Ayoubi JM, Righini C, Olivennes F, Schonauer LM, Frydman R. Uterine contractility decreases at the time of blastocyst transfers. Hum Reprod. 2001;16:1115–9.CrossRefGoogle Scholar
  13. 13.
    Bu Z, Wang K, Dai W, Sun Y. Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles. Gynecol Endocrinol. 2016:1–5.Google Scholar
  14. 14.
    Fang R, Cai L, Xiong F, Chen J, Yang W, Zhao X. The effect of endometrial thickness on the day of hCG administration on pregnancy outcome in the first fresh IVF/ICSI cycle. Gynecol Endocrinol. 2016:1–4.Google Scholar
  15. 15.
    Lebovitz O, Orvieto R. Treating patients with “thin” endometrium - an ongoing challenge. Gynecol Endocrinol. 2014;30:409–14.CrossRefGoogle Scholar
  16. 16.
    Al-Ghamdi A, Coskun S, Al-Hassan S, Al-Rejjal R, Awartani K. The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reprod Biol Endocrinol. 2008;6:37.CrossRefGoogle Scholar
  17. 17.
    Zhao J, Zhang Q, Li Y. The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles. Reprod Biol Endocrinol. 2012;10:100.CrossRefGoogle Scholar
  18. 18.
    Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril. 2007;87:53–9.CrossRefGoogle Scholar
  19. 19.
    Dain L, Bider D, Levron J, Zinchenko V, Westler S, Dirnfeld M. Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation? Fertil Steril. 2013;100:1289–95.CrossRefGoogle Scholar
  20. 20.
    Amui J, Check JH, Cohen R. Successful twin pregnancy in a donor oocyte recipient despite a maximum endometrial thickness in the late proliferative phase of 4 mm. Clin Exp Obstet Gynecol. 2012;38:328–9.Google Scholar
  21. 21.
    Fanchin R, Righini C, Ayoubi JM, Olivennes F, de Ziegler D, Frydman R. Uterine contractions at the time of embryo transfer: a hindrance to implantation? Contracept Fertil Sex. 1998;26:498–505.Google Scholar
  22. 22.
    Lesny P, Killick SR, Tetlow RL, Robinson J, Maguiness SD. Embryo transfer--can we learn anything new from the observation of junctional zone contractions? Hum Reprod. 1998;13:1540–6.CrossRefGoogle Scholar
  23. 23.
    Zhu L, Li Y, Xu A. Influence of controlled ovarian hyperstimulation on uterine peristalsis in infertile women. Hum Reprod. 2012;27:2684–9.CrossRefGoogle Scholar
  24. 24.
    Casper RF, Yanushpolsky EH. Optimal endometrial preparation for frozen embryo transfer cycles: window of implantation and progesterone support. Fertil Steril. 2016;105:867–72.CrossRefGoogle Scholar
  25. 25.
    Zhu L, Che HS, Xiao L, Li YP. Uterine peristalsis before embryo transfer affects the chance of clinical pregnancy in fresh and frozen-thawed embryo transfer cycles. Hum Reprod. 2014;29:1238–43.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Nivin Samara
    • 1
    • 2
  • Robert F. Casper
    • 1
    • 3
  • Rawad Bassil
    • 1
  • Mahvash Shere
    • 1
  • Eran Barzilay
    • 4
  • Raoul Orvieto
    • 4
    • 5
  • Jigal Haas
    • 1
    • 4
    Email author
  1. 1.TRIO fertility partnersTorontoCanada
  2. 2.The Fertility InstituteLis Maternity Hospital, Sourasky Medical CenterTel- AvivIsrael
  3. 3.Division of Reproductive SciencesUniversity of Toronto, Lunenfeld-Tanenbaum Research Institute, Mount Sinai HospitalTorontoCanada
  4. 4.Infertility and IVF Unit, Department of Obstetrics and GynecologyChaim Sheba Medical Center (Tel Hashomer), Tel -Aviv UniversityRamat GanIsrael
  5. 5.Tarnesby-Tarnowski Chair for Family Planning and Fertility Regulation, Sackler Faculty of MedicineTel-Aviv UniversityTel Aviv-YafoIsrael

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