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3D-Endometrial volume and outcome of cryopreserved embryo replacement cycles

  • Reproductive Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

The success of artificial reproductive techniques not only depends on the quality of oocytes and spermatozoa but also on the receptivity of the endometrium. The aim of this study was to assess the value of measurement of endometrial volume by three-dimensional (3D) in comparison to 2D-ultrasound in the prediction of implantation in women having transfer of cryopreserved embryos.

Methods

One hundred and eight couples were included in this prospective study. All patients underwent the IVF or ICSI program and had transfer of cryopreserved embryos. Sixty-eight transfers were done in a spontaneous cycle and 40 in an artificial cycle. Endometrial thickness, pattern and three-dimensional volume were measured immediately before embryo transfer.

Results

Twenty clinical pregnancies were achieved (PR 18.5 % per transfer), the PR being similar in spontaneous (22.1 %) and artificial (12.5 %, ns) cycles. Three to five days after ovulation (spontaneous cycles) or after the endometrium reached a thickness of at least 8 mm (artificial cycles), a median of three embryos were replaced. In spontaneous cycles, there were no significant differences in endometrial thickness or volume between pregnant (11.9 mm, 2.9 ml) and non-pregnant women (10.7 mm, 3.4 ml). In artificial cycles, the endometrial volume (3.9 vs. 2.5 ml, p < 0.05), but not endometrial thickness (10.7 vs. 10.2 mm, ns) was significantly higher in pregnant than in non-pregnant women.

Conclusions

In artificial cycles, a low endometrial volume is associated with a poor likelihood of implantation. Endometrial volume measured by 3D-ultrasound is an objective parameter to predict endometrial receptivity.

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References

  1. Bohrer MK, Hock DL (1996) Sonographic assessment of endometrial pattern and thickness in patients treated with human menopausal gonadotropins. Fertil Steril 66:244–247

    PubMed  CAS  Google Scholar 

  2. Hock DL, Bohrer MK, Ananth CV, Kemmann E (1997) Sonographic assessment of endometrial pattern and thickness in patients treated with clomiphene citrate, human menopausal gonadotropins, and intrauterine insemination. Fertil Steril 68:242–245

    Article  PubMed  CAS  Google Scholar 

  3. Oliveira JBA, Baruffi RLR, Mauri AL, Petersen CG, Borges MC, Franco JG Jr (1997) Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme after ovarian stimulation and gonadotrophin-releasing hormone and gonadotrophins. Hum Reprod 12:2515–2518

    Article  PubMed  CAS  Google Scholar 

  4. Tsai HD, Chang CC, Hsieh YY, Lee CC, Lo HY (2000) Artificial insemination. Role of endometrial thickness and pattern, of vascular impedance of the spiral and uterine arteries, and of the dominant follicle. J Reprod Med 45:195–200

    PubMed  CAS  Google Scholar 

  5. Friedler S, Schenker JG, Herman A, Lewin A (1996) The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Hum Reprod Update 2:323–335

    Article  PubMed  CAS  Google Scholar 

  6. Kyei-Mensah A, Maconochie M, Zaidi J, Pittrof R, Campbell S, Tan SL (1996) Transvaginal three-dimensional ultrasound: reproducibility of ovarian and endometrial volume measurements. Fertil Steril 66:718–722

    PubMed  CAS  Google Scholar 

  7. Lee A, Sator M, Kratochwill A, Deutinger J, Vytiska-Binsdorfer E, Bernaschek G (1997) Endometrial volume change during spontaneous menstrual cycles: volumetry by transvaginal three-dimensional ultrasound. Fertil Steril 68:831–835

    Article  PubMed  CAS  Google Scholar 

  8. Yaman C, Sommergruber M, Ebner T, Pölz W, Moser M, Tews G (1999) Reproducibility of transvaginal three-dimensional endometrial volume measurements during ovarian stimulation. Hum Reprod 14:2604–2608

    Article  PubMed  CAS  Google Scholar 

  9. Bordes A, Bory AM, Benchaib M, Rudugoz RC, Salle B (2002) Reproducibility of transvaginal three-dimensional endometrial volume measurements with virtual organ computer-aided analysis (VOCAL) during ovarian stimulation. Ultrasound Obstet Gynecol 19:76–80

    Article  PubMed  CAS  Google Scholar 

  10. Raine-Fenning N, Campbell B, Collier J, Brincat M, Johnson I (2002) The reproducibility of endometrial volume acquisition and measurement with the VOCAL-imaging program. Ultrasound Obstet Gynecol 19:69–75

    Article  PubMed  CAS  Google Scholar 

  11. Raga F, Bonilla-Musoles F, Casan EM, Klein O, Bonilla F (1999) Assessment of endometrial volume by three-dimensional ultrasound prior to embryo transfer: clues to endometrial receptivity. Hum Reprod 14:2851–2854

    Article  PubMed  CAS  Google Scholar 

  12. Zollner U, Zollner KP, Specketer MT, Blissing S, Müller T, Steck T, Dietl J (2003) Endometrial volume as assessed by three-dimensional ultrasound is a predictor of pregnancy outcome after in vitro fertilization and embryo transfer. Fertil Steril 80:1515–1517

    Article  PubMed  Google Scholar 

  13. Zollner U, Schleyer M, Steck T (1996) Evaluation of a cut-off value for normal sperm morphology using strict criteria to predict fertilization after conventional in-vitro fertilization and embryo transfer in asthenozoospermia. Hum Reprod 11:2155–2161

    Article  PubMed  CAS  Google Scholar 

  14. Zollner U, Zollner KP, Dietl J, Steck T (2001) Semen sample collection in medium enhances the implantation rate following Intracytoplasmic sperm injection (ICSI) in patients with severe oligoasthenoteratozoospermia. Hum Reprod 16:1110–1114

    Article  PubMed  CAS  Google Scholar 

  15. Yaman C, Ebner T, Sommergruber M, Pölz W, Tews G (2000) Role of three-dimensional ultrasonographic measurement of endometrium volume as predictor of pregnancy outcome in an IVF-ET program: a preliminary study. Fertil Steril 74:797–801

    Article  PubMed  CAS  Google Scholar 

  16. Tsai YC, Tai MC, Chang JC (1995) Predictive value of endometrial sonography in ovulation induction for intrauterine insemination. J Formos Med Assoc 94:626–629

    PubMed  CAS  Google Scholar 

  17. Lesny P, Killick SR, Tetlow RL, Manton DJ, Robinson J, Maguiness SD (1999) Ultrasound evaluation of the uterine zonal anatomy during in-vitro fertilization and embryo transfer. Hum Reprod 14:1593–1598

    Article  PubMed  CAS  Google Scholar 

  18. Reuter KL, Cohen S, Furey L, Baker S (1996) Sonographic appearance of the endometrium and ovaries during cycles stimulated with human menopausal gonadotropin. J Reprod Med 41:509–514

    PubMed  CAS  Google Scholar 

  19. Isaacs JD Jr, Wells CS, Williams DB, Odem RR, Gast MJ, Strickler RC (1996) Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone. Fertil Steril 65:262–266

    PubMed  Google Scholar 

  20. Tan SL (1999) Clinical applications of Doppler and three-dimensional ultrasound in assisted reproductive technology. Ultrasound Obstet Gynecol 13:153–156

    Article  PubMed  CAS  Google Scholar 

  21. Baba K, Ishihara O, Hayashi N, Saitoh M, Taya J, Kinoshita K (2000) Three-dimensional ultrasound in embryo transfer. Ultrasound Obstet Gynecol 16:372–373

    Article  PubMed  CAS  Google Scholar 

  22. Mercé LT, Barco MJ, Bau S, Troyano J (2008) Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome? Fertil Steril 89:111–117

    Article  PubMed  Google Scholar 

  23. Schwartz LB, Chiu AS, Courtney M, Krey L, Schmidt-Sarosi C (1997) The embryo versus endometrium controversy revisited as it relates to predicting pregnancy outcome in in-vitro fertilization-embryo transfer cycles. Hum Reprod 12:45–50

    Article  PubMed  CAS  Google Scholar 

  24. Ng EH, Chan CC, Tang OS, Yeung WS, Ho P (2006) The role of endometrial and subendometrial vascularity measured by three-dimensional power Doppler ultrasound in the prediction of pregnancy during frozen-thawed embryo transfer cycles. Hum Reprod 21:1612–1617

    Article  PubMed  Google Scholar 

  25. Zácková T, Järvelä IY, Tapanainen JS, Feyereisl J (2009) Assessment of endometrial and ovarian characteristics using three dimensional power Doppler ultrasound to predict response in frozen embryo transfer cycles. Reprod Biol Endocrinol 7:151

    Article  PubMed  Google Scholar 

  26. El-Toukhy T, Coomarasamy A, Khairy M, Sunkara K, Seed P, Khalaf Y, Braude P (2008) The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles. Fertil Steril 89:832–839

    Article  PubMed  Google Scholar 

  27. Leal Almeida M, Saucedo de la Llata E, Batiza Resendiz V, Santos Haliscak R, Galache Vega P, Hernández Ayup S (2004) Endometrial thickness. Prognostic factor in assisted reproduction? Ginecol Obstet Mex 72:116–119

    PubMed  Google Scholar 

  28. Ng EH, Chan CC, Tang OS, Yeung WS, Ho PC (2007) Endometrial and subendometrial vascularity is higher in pregnant patients with livebirth following ART than in those who suffer a miscarriage. Hum Reprod 22:1134–1141

    Article  PubMed  Google Scholar 

  29. Alcázar JL (2006) Three-dimensional ultrasound assessment of endometrial receptivity: a review. Reprod Biol Endocrinol 4:56

    Article  PubMed  Google Scholar 

  30. Dix E, Check JH (2010) Successful pregnancies following embryo transfer despite very thin late proliferative endometrium. Clin Exp Obstet Gynecol 37:15–16

    PubMed  CAS  Google Scholar 

  31. Check JH, Bostick-Smith CA, Choe JK, Amui J, Brasile D (2011) Matched controlled study to evaluate the effect of endometrial polyps on pregnancy and implantation rates following in vitro fertilization-embryo transfer (IVF-ET). Clin Exp Obstet Gynecol 38:206–208

    PubMed  CAS  Google Scholar 

  32. Lass A, Williams G, Abusheikha N, Brinsden P (1999) The effect of endometrial polyps on outcomes of in vitro fertilization (IVF) cycles. J Assist Reprod Genet 16:410–415

    Article  PubMed  CAS  Google Scholar 

  33. Senturk LM, Erel CT (2008) Thin endometrium in assisted reproductive technology. Curr Opin Obstet Gynecol 20:221–228

    Article  PubMed  Google Scholar 

  34. Broussin B (2007) The clinical value of ultrasound for endometrial receptivity assessment in Assisted Reproductive Techniques (ART) procedures. Gynecol Obstet Fertil 35:570–575

    Article  PubMed  CAS  Google Scholar 

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Universitäts-Frauenklinik Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany

    Ursula Zollner & Johannes Dietl

  2. Frauenklinik der Krankenhaus Nordwest GmbH, Steinbacher Hohl 2, 60488, Frankfurt am Main, Germany

    Marie-Theres Specketer

  3. Kinderwunschzentrum Amberg, Mariahilfbergweg 7, 92225, Amberg, Germany

    Klaus-Peter Zollner

  4. Department of Obstetrics and Gynecology, University of Würzburg, Josef-Schneider-Strasse 4, 97080, Würzburg, Germany

    Ursula Zollner

Authors
  1. Ursula Zollner
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  2. Marie-Theres Specketer
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  3. Johannes Dietl
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  4. Klaus-Peter Zollner
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Correspondence to Ursula Zollner.

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Zollner, U., Specketer, MT., Dietl, J. et al. 3D-Endometrial volume and outcome of cryopreserved embryo replacement cycles. Arch Gynecol Obstet 286, 517–523 (2012). https://doi.org/10.1007/s00404-012-2332-4

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  • DOI: https://doi.org/10.1007/s00404-012-2332-4

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