1. Home
  2. Vol 29, No 9 (2025)
  3. Yu

Prediction of clinical pregnancy in in-vitro fertilization-embryo transfer by transvaginal three-dimensional ultrasonography and serum hormone levels

Yanxia Yu(1), Jia Xing(2), Huiqin Xiao(3), Lijuan Jiang(4),


(1) Department of Gynaecology and obstetrics, Chun'an Hospital of Traditional Chinese Medicine, Zhejiang Hangzhou 311700, China
(2) Department of II (Traditional Chinese Medicine), Hangzhou Hospital of Traditional Chinese Medicine, Gynecology, Zhejiang Hangzhou, 310007, China
(3) Department of Gynaecology and obstetrics, Chun'an Hospital of Traditional Chinese Medicine, Zhejiang Hangzhou 311700, China
(4) Department of Gynaecology and obstetrics, Chun'an Hospital of Traditional Chinese Medicine, Zhejiang Hangzhou 311700, China
Corresponding Author

Abstract


This study aimed to explore the predictive value of transvaginal three-dimensional ultrasonography combined with serum progesterone and estrogen levels in in-vitro fertilization-embryo transfer. A total of 100 patients undergoing frozen-thawed embryo cycles were investigated. On the day before embryo transfer, two-dimensional ultrasound was used to assess endometrial thickness and blood flow parameters, including the resistance index, pulsatility index, and systolic/diastolic velocity ratio. These measurements were then transitioned to three-dimensional ultrasound, where endometrial volume, flow index, vascularization flow index, and sub endometrial vascularization index were evaluated. On the day of embryo transfer, serum progesterone and estradiol levels were measured. Based on pregnancy outcomes, patients were divided into pregnant and non-pregnant groups. The results showed no significant differences between the groups in terms of endometrial thickness or two-dimensional ultrasound parameters (P>0.05). However, the pregnant group had significantly higher endometrial volume and sub-endometrial vascularization parameters (P<0.05). The combined predictive value of endometrial volume and serum estrogen was 0.735, with sensitivity of 77.3% and specificity of 90.7%. These findings suggest that three-dimensional ultrasonography, in conjunction with serum estrogen levels, can accurately predict clinical pregnancy outcomes in IVF-ET.

References


Carson SA and Kallen AN. Diagnosis and Management of

Infertility: A Review. JAMA. 2021 Jul 6;326(1):65

Mizrachi Y and McQueen DB. Embryo transfer success: It is

in our hands. Fertil Steril. 2022 Nov;118(5):815-819.

Yu J, Li B, Li H, Li Q, Nai Z, Deng B and Li Y. Comparison

of uterine, endometrial and subendometrial blood

flows in predicting pregnancy outcomes between

fresh and frozen-thawed embryo transfer after GnRH

antagonist protocol: a retrospective cohort study. J

Obstet Gynaecol. 2023 Dec;43(1):2195937.

Franasiak JM, Alecsandru D, Forman EJ, Gemmell LC,

Goldberg JM, Llarena N, Margolis C, Laven J,

Schoenmakers S and Seli E. A review of the

pathophysiology of recurrent implantation failure.

Fertil Steril. 2021 Dec;116(6):1436-1448.

Nandi A, Martins WP, Jayaprakasan K, Clewes JS, Campbell

BK and Raine-Fenning NJ. Assessment of

endometrial and subendometrial blood flow in

women undergoing frozen embryo transfer cycles.

Reprod Biomed Online. 2014 Mar;28(3):343-51. doi:

1016/j.rbmo.2013.11.004.

Choi YJ, Lee HK and Kim SK. Doppler ultrasound

investigation of female infertility. Obstet Gynecol

Sci. 2023 Mar;66(2):58-68.

Bahrami F, Eftekhar M and Zanbagh L. Uterine artery

Doppler and endometrial blood flow in frozen

embryo transfer: A cohort study. Int J Reprod

Biomed. 2023 Apr 14;21(3):205-212

Boza A, Oznur D A, Mehmet C, Gulumser A and Bulent U.

Endometrial volume measured on the day of embryo

transfer is not associated with live birth rates in IVF:

a prospective study and review of the literature[J].

Journal of Gynecology Obstetrics and Human

Reproduction, 2020: 101767.

Chen T, Zhao F, Wang Q, Liu L, Zhang L, Li J and Li Z..

Salpingectomy may decrease antral follicle count but

not live birth rate for IVF-ET patients aged 35–39 years: a retrospective study[J]. Journal of Ovarian

Research, 2020, 13(1): 1-8

Wang X, Bao N, Xin X, Tan J, Li H, Zhou S and Liu H.

Automatic evaluation of endometrial receptivity in

three-dimensional transvaginal ultrasound images

based on 3D U-Net segmentation. Quant Imaging

Med Surg. 2022 Aug;12(8):4095-4108.

Kamel AM, Abu-Hamila F, Elkomy RO, Hamed SA, Samy

M and Gaballah MA. The measurement of

endometrial volume and sub-endometrial vascularity

to replace the traditional endometrial thickness as

predictors of in-vitro fertilization success. Gynecol

Endocrinol. 2019 Nov;35(11):949-954.

Papic OM, Dragojevic DS, Mitrovic A, Miljkovic S and Ilic

V. Correlation analysis of pre-dictive factor of successful implantation in fertilization in vitro［J］.

Srpski Arhivza Celokupno Lekarstvo，2003，131( 7

/8) : 311-313．

Romanski PA, Bortoletto P, Liu YL, Chung PH and

Rosenwaks Z. Length of estradiol exposure >100

pg/ml in the follicular phase affects pregnancy

outcomes in natural frozen embryo transfer cycles.

Hum Reprod. 2021 Jun 18;36(7):1932-1940.

Gomaa IA, Sabry A, Allam ISE, Ashoush S and Reda A.

Endometrial Progesterone and Estrogen Receptors in

Relation to Hormonal Levels in Women with

Unexplained Recurrent Miscarriage. Rev Bras

Ginecol Obstet. 2023 Nov;45(11):e676-e682.


Full Text: PDF

Article Metrics

Abstract View : 323 times
PDF Download : 224 times

Refbacks

  • There are currently no refbacks.