PhD: The role of ultrasound in the evaluation of endometrial receptivity following IVF – ET treatments

BACKGROUND: The endometrial receptivity is defined as a temporary sequence of factors which make the endometrium receptive for embryonic implantation. Ultrasound, as a noninvasive, accessible method gives practical possibility for evaluation and prediction of the endometrial receptivity before and during the realization of the embryo-transfer. AIM: The aim of this study is to assess the meaning of the ultrasound parameters during the prediction of endometrial receptivity expressed through the outcome of the IVF-ET procedure. MATERIAL AND METHODS: The study consisted of 160 patients whose age varied between the intervals of 24-42 years. Out of 160 patients included in the study, 66 (41.25%) got pregnant, while 94 (58.75%) did not. RESULTS: There was no statistical significant diference (χ2 = 0.46 and p > 0.05) (p=1.00/ Fisher) according pregnancy rates regarding the endometrial thickness. Also, there was no statistical significant diference, p>0.05 (p=1.00/ Fisher) according to pregnancy rates regarding the endometrial pattern. The mean endometrial value was 3.27± 0.69 (± 2SD) in range 1,7 – 7.9 ml. The patients with endometrial volume of 0.05 (p = 0.24) / Fisher, have no significant difference of the outcome in relation to whether or not there was a penetration of the blood vessels in the subendometrum. Of 9 pregnant women at whom a penetration of the blood vessels in the subendometrum and endometrium was not registered, 5 (55.55%) had an abortion. For p 40), and VFI (>20), significantly associated with a higher pregnancy rate (p<0.05). Regarding the embryo transfer in relation to the distance between the top of the catheter and fundus uteri, the analysis of results showed that the pregnancy rate is significantly dependant on the distance from the top of the catheter to fundus uteri during the embryo transfer, during which the pregnancy rate significantly decreases from 48.7% at group B (low embryo transfer) to 34.5% at group A (middle/high embryo transfer) (p<0.05). CONCLUSIONS: The results of the study suggest that the ultrasound examination can be successfully conducted in order to observe the dynamic and vascular changes at uterus level from the follicular to the early-middle luteal phase, with the aim of confirming the correlation between the physiological implantation processes and the implantation potential, that gives an opportunity to perceive the reasons for the unsuccessful IVF attempts and the eventual therapeutic modalities for their improvement.