Ultrasound evaluation of endometrial receptivity to predict the clinical pregnancy outcome of IVF-ET: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

YU Zhen ^1,2 ,  TANG Ying ^1,2 , LONG Youlin ³ , QIN Xiyu ^1,2 , YANG Jie ^1,2 , YANG Haibo ^1,2

1. Department of Ultrasound, West China Second Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Key Laboratory of Obstetric & Gynecologic and Pediatric Disease and Birth Defects, Ministry of Education, Chengdu 610041, P. R. China;
3. Chinese Evidence-based Medicine, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

TANG Ying, Email: tangy_cd@163.com

Keywords：

Endometrial receptivity; IVF-ET; Ultrasonography; Pregnancy outcome; Meta-analysis

DOI：

10.7507/1672-2531.202111125

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the endometrial receptivity evaluated by transvaginal ultrasound and predict the clinical pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on transvaginal ultrasound evaluation of endometrial receptivity to predict the clinical pregnancy outcome of IVF-ET from inception to December 1^st, 2021. Two researchers independently screened literature, extracted data and evaluated the risk of bias of the included studies. RevMan 5.4 software and Stata 16.0 software were used to perform meta-analysis. Results A total of 24 cohort studies and 1 case-control study were included. The total sample size was 6 632 cases, including 3 340 in non-pregnancy group and 3 292 in pregnancy group. The results of meta-analysis showed that there was no difference in endometrial volume (MD=?0.11, 95%CI ?0.33 to 0.11, P=0.34) or uterine artery S/D (MD= ?0.04, 95%CI ?0.17 to 0.09, P=0.55) between the two groups. The endometrial thickness measured on human chorionic gonadotrophin (HCG) day in the non-pregnant group (MD=?0.48, 95%CI ?0.77 to ?0.18, P=0.001) was thinner than that in the pregnant group. On embryo transfer (ET) day, uterine artery pulsatility index (PI) (MD=0.08, 95%CI 0.02 to 0.15, P=0.01) and resistance index (RI) (MD=0.01, 95%CI 0.01 to 0.01, P<0.000 01) were higher than those in the pregnancy group. Conclusion Endometrial volume and uterine artery S/D measured during IVF-ET were not correlated with clinical pregnancy outcome, while endometrial thickness measured on HCG day and uterine artery PI and RI measured on ET day were correlated with clinical pregnancy outcome. Transvaginal ultrasound evaluation of endometrial receptivity has a certain predictive value for clinical pregnancy outcome of IVF-ET. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.

Citation： YU Zhen, TANG Ying, LONG Youlin, QIN Xiyu, YANG Jie, YANG Haibo. Ultrasound evaluation of endometrial receptivity to predict the clinical pregnancy outcome of IVF-ET: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2022, 22(3): 284-290. doi: 10.7507/1672-2531.202111125 Copy

1.	卜曉萌, 賈嬋維, 王樹玉. 子宮內膜微生態與不孕癥及IVF-ET結局的相關性研究. 中國優生與遺傳雜志, 2021, 29(4): 590-592.
2.	劉耘利, 許偉標, 劉瓊珠, 等. 經陰道三維超聲對體外受精-胚胎移植患者子宮內膜容受性的評估及對妊娠結局的預測價值. 中國臨床醫學影像雜志, 2021, 32(6): 426-431.
3.	Wang J, Xia F, Zhou Y, et al. Association between endometrial/subendometrial vasculature and embryo transfer outcome: a meta-analysis and subgroup analysis. J Ultrasound Med, 2018, 37(1): 149-163.
4.	蔣振林, 朱澤靜, 唐麗. 超聲監測子宮內膜對IVF-ET妊娠結局的預測價值. 中國計劃生育學雜志, 2021, 29(10): 2126-2128.
5.	楊彬, 王薇, 茍永賢, 等. 陰道三維超聲評估子宮內膜容受性預測體外受精-胚胎移植后妊娠結局的臨床價值. 臨床醫學研究與實踐, 2020, 5(29): 135-136.
6.	李芷舒, 魯海鷗, 張宇明, 等. 不孕患者移植當日子宮內膜容受性評估對臨床妊娠率影響研究. 中國實用婦科與產科雜志, 2020, 36(3): 264-266.
7.	陳慧佳, 吳藝佳, 張覘宇, 等. 彩色多普勒超聲檢查預測凍融胚胎解凍移植妊娠結局的價值. 檢驗醫學與臨床, 2019, 16(13): 1819-1822.
8.	楊文秀. 經陰道三維超聲評價凍融胚胎移植周期子宮內膜容受性的研究. 濟南: 山東大學, 2017.
9.	姚麗婷, 黃樞, 閆建平, 等. 子宮內膜容積和內膜下血流對子宮內膜容受性影響的比較. 臨床軍醫雜志, 2015, 43(4): 388-390,396.
10.	Prasad S, Goyal R, Kumar Y, et al. The relationship between uterine artery two-dimensional color Doppler measurement and pregnancy outcome: a prospective observational study. J Reprod Infertil, 2017, 18(2): 251-256.
11.	Nandi A, Martins WP, Jayaprakasan K, et al. Assessment of endometrial and subendometrial blood flow in women undergoing frozen embryo transfer cycles. Reprod Biomed Online, 2014, 28(3): 343-351.
12.	劉燦華, 孔鳳貝, 王曉萍, 等. 經陰道彩色多普勒超聲對IVF-ET中子宮內膜容受性的評估價值. 南昌大學學報(醫學版), 2014, 54(4): 38-40,44.
13.	Son JB, Jeong JE, Joo JK, et al. Measurement of endometrial and uterine vascularity by transvaginal ultrasonography in predicting pregnancy outcome during frozen-thawed embryo transfer cycles. J Obstet Gynaecol Res, 2014, 40(6): 1661-1667.
14.	Zhao J, Zhang Q, Wang Y, et al. Endometrial pattern, thickness and growth in predicting pregnancy outcome following 3319 IVF cycle. Reprod Biomed Online, 2014, 29(3): 291-298.
15.	李江濤, 曹金麗, 程傳生, 等. 經陰道三維超聲在凍融胚胎解凍移植時機選擇中的運用價值. 中華臨床醫師雜志(電子版), 2013, (9): 3782-3785.
16.	王曉紅. 彩色多普勒超聲檢測子宮內膜參數在預測IVF-ET結局的作用. 太原: 山西醫科大學, 2012.
17.	王麗娜, 蘇雪松, 喬杰, 等. 子宮內膜內及子宮內膜下血流對胚胎解凍移植周期妊娠結局的影響. 中國微創外科雜志, 2012, 12(3): 245-249.
18.	屈文娟, 姜宏, 羅福成, 等. 經陰道彩色多普勒超聲在IVF-ET中對子宮內膜容受性的評估價值. 中國超聲醫學雜志, 2011, 27(11): 1027-1030.
19.	Engels V, Sanfrutos L, Pérez-Medina T, et al. Evaluation of endometrial and subendometrial vascularization and endometrial volume by 3-D power Doppler ultrasound and its relationship with age and pregnancy in intrauterine insemination cycles. Gynecol Obstet Invest, 2011, 72(2): 117-122.
20.	Yilmaz N, Kilic S, Madendag Y, et al. Endometrial parameters in IVF and IUI administration on elderly women. Turk J Med Sci, 2010, 40(3): 343-348.
21.	Zácková T, J?rvel? IY, Tapanainen JS, et al. Assessment of endometrial and ovarian characteristics using three dimensional power Doppler ultrasound to predict response in frozen embryo transfer cycles. Reprod Biol Endocrinol, 2009, 7: 151.
22.	Mercé LT, Barco MJ, Bau S, et al. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome. Fertil Steril, 2008, 89(1): 111-117.
23.	張清學, 邢衛杰, 文艷玲, 等. 彩色超聲多普勒評價子宮內膜容受性的價值. 中國超聲醫學雜志, 2006, 22(5): 375-377.
24.	劉紅梅, 邢福祺, 陳士嶺. 經陰道超聲對體外受精-胚胎移植中子宮內膜容受性的評價. 中國超聲醫學雜志, 2005, (11): 66-68.
25.	張宜生, 周馥貞, 應偉雯. 三維超聲測定子宮內膜容積預測IVFET結局. 實用婦產科雜志, 2005, 21(6): 375-377.
26.	Chien LW, Lee WS, Au HK, et al. Assessment of changes in utero-ovarian arterial impedance during the peri-implantation period by Doppler sonography in women undergoing assisted reproduction. Ultrasound Obstet Gynecol, 2004, 23(5): 496-500.
27.	Wu HM, Chiang CH, Huang HY, et al. Detection of the subendometrial vascularization flow index by three-dimensional ultrasound may be useful for predicting the pregnancy rate for patients undergoing in vitro fertilization-embryo transfer. Fertil Steril, 2003, 79(3): 507-511.
28.	Cacciatore B, Simberg N, Fusaro P, et al. Transvaginal Doppler study of uterine artery blood flow in in vitro fertilization-embryo transfer cycles. Fertil Steril, 1996, 66(1): 130-134.
29.	裴紅, 姜宏, 張文香, 等. 體外受精-胚胎移植中子宮內膜超聲參數與妊娠率的相關性. 生殖醫學雜志, 2009, 18(4): 390-392.
30.	Schild RL, Knobloch C, Dorn C, et al. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril, 2001, 75(2): 361-366.
31.	唐志霞, 洪名云, 張玲, 等. 子宮動脈及子宮內膜血流對體外受精-胚胎移植結局的影響. 中國計劃生育和婦產科, 2015, 7(7): 15-17.
32.	Sun Y, Huang J, Kong HF. Spontaneous rupture of unscarred uterus in the third trimester after in vitro fertilization-embryo transfer because of bilateral salpingectomy: A case report. Medicine (Baltimore), 2019, 98(48): e18182.
33.	Shang J, Peng R, Zheng J, et al. The indicator of clinical outcomes for patients with heterotopic pregnancy following in-vitro fertilization with embryo transfer. Taiwan J Obstet Gynecol, 2019, 58(6): 827-832.

1. 卜曉萌, 賈嬋維, 王樹玉. 子宮內膜微生態與不孕癥及IVF-ET結局的相關性研究. 中國優生與遺傳雜志, 2021, 29(4): 590-592.
2. 劉耘利, 許偉標, 劉瓊珠, 等. 經陰道三維超聲對體外受精-胚胎移植患者子宮內膜容受性的評估及對妊娠結局的預測價值. 中國臨床醫學影像雜志, 2021, 32(6): 426-431.
3. Wang J, Xia F, Zhou Y, et al. Association between endometrial/subendometrial vasculature and embryo transfer outcome: a meta-analysis and subgroup analysis. J Ultrasound Med, 2018, 37(1): 149-163.
4. 蔣振林, 朱澤靜, 唐麗. 超聲監測子宮內膜對IVF-ET妊娠結局的預測價值. 中國計劃生育學雜志, 2021, 29(10): 2126-2128.
5. 楊彬, 王薇, 茍永賢, 等. 陰道三維超聲評估子宮內膜容受性預測體外受精-胚胎移植后妊娠結局的臨床價值. 臨床醫學研究與實踐, 2020, 5(29): 135-136.
6. 李芷舒, 魯海鷗, 張宇明, 等. 不孕患者移植當日子宮內膜容受性評估對臨床妊娠率影響研究. 中國實用婦科與產科雜志, 2020, 36(3): 264-266.
7. 陳慧佳, 吳藝佳, 張覘宇, 等. 彩色多普勒超聲檢查預測凍融胚胎解凍移植妊娠結局的價值. 檢驗醫學與臨床, 2019, 16(13): 1819-1822.
8. 楊文秀. 經陰道三維超聲評價凍融胚胎移植周期子宮內膜容受性的研究. 濟南: 山東大學, 2017.
9. 姚麗婷, 黃樞, 閆建平, 等. 子宮內膜容積和內膜下血流對子宮內膜容受性影響的比較. 臨床軍醫雜志, 2015, 43(4): 388-390,396.
10. Prasad S, Goyal R, Kumar Y, et al. The relationship between uterine artery two-dimensional color Doppler measurement and pregnancy outcome: a prospective observational study. J Reprod Infertil, 2017, 18(2): 251-256.
11. Nandi A, Martins WP, Jayaprakasan K, et al. Assessment of endometrial and subendometrial blood flow in women undergoing frozen embryo transfer cycles. Reprod Biomed Online, 2014, 28(3): 343-351.
12. 劉燦華, 孔鳳貝, 王曉萍, 等. 經陰道彩色多普勒超聲對IVF-ET中子宮內膜容受性的評估價值. 南昌大學學報(醫學版), 2014, 54(4): 38-40,44.
13. Son JB, Jeong JE, Joo JK, et al. Measurement of endometrial and uterine vascularity by transvaginal ultrasonography in predicting pregnancy outcome during frozen-thawed embryo transfer cycles. J Obstet Gynaecol Res, 2014, 40(6): 1661-1667.
14. Zhao J, Zhang Q, Wang Y, et al. Endometrial pattern, thickness and growth in predicting pregnancy outcome following 3319 IVF cycle. Reprod Biomed Online, 2014, 29(3): 291-298.
15. 李江濤, 曹金麗, 程傳生, 等. 經陰道三維超聲在凍融胚胎解凍移植時機選擇中的運用價值. 中華臨床醫師雜志(電子版), 2013, (9): 3782-3785.
16. 王曉紅. 彩色多普勒超聲檢測子宮內膜參數在預測IVF-ET結局的作用. 太原: 山西醫科大學, 2012.
17. 王麗娜, 蘇雪松, 喬杰, 等. 子宮內膜內及子宮內膜下血流對胚胎解凍移植周期妊娠結局的影響. 中國微創外科雜志, 2012, 12(3): 245-249.
18. 屈文娟, 姜宏, 羅福成, 等. 經陰道彩色多普勒超聲在IVF-ET中對子宮內膜容受性的評估價值. 中國超聲醫學雜志, 2011, 27(11): 1027-1030.
19. Engels V, Sanfrutos L, Pérez-Medina T, et al. Evaluation of endometrial and subendometrial vascularization and endometrial volume by 3-D power Doppler ultrasound and its relationship with age and pregnancy in intrauterine insemination cycles. Gynecol Obstet Invest, 2011, 72(2): 117-122.
20. Yilmaz N, Kilic S, Madendag Y, et al. Endometrial parameters in IVF and IUI administration on elderly women. Turk J Med Sci, 2010, 40(3): 343-348.
21. Zácková T, J?rvel? IY, Tapanainen JS, et al. Assessment of endometrial and ovarian characteristics using three dimensional power Doppler ultrasound to predict response in frozen embryo transfer cycles. Reprod Biol Endocrinol, 2009, 7: 151.
22. Mercé LT, Barco MJ, Bau S, et al. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome. Fertil Steril, 2008, 89(1): 111-117.
23. 張清學, 邢衛杰, 文艷玲, 等. 彩色超聲多普勒評價子宮內膜容受性的價值. 中國超聲醫學雜志, 2006, 22(5): 375-377.
24. 劉紅梅, 邢福祺, 陳士嶺. 經陰道超聲對體外受精-胚胎移植中子宮內膜容受性的評價. 中國超聲醫學雜志, 2005, (11): 66-68.
25. 張宜生, 周馥貞, 應偉雯. 三維超聲測定子宮內膜容積預測IVFET結局. 實用婦產科雜志, 2005, 21(6): 375-377.
26. Chien LW, Lee WS, Au HK, et al. Assessment of changes in utero-ovarian arterial impedance during the peri-implantation period by Doppler sonography in women undergoing assisted reproduction. Ultrasound Obstet Gynecol, 2004, 23(5): 496-500.
27. Wu HM, Chiang CH, Huang HY, et al. Detection of the subendometrial vascularization flow index by three-dimensional ultrasound may be useful for predicting the pregnancy rate for patients undergoing in vitro fertilization-embryo transfer. Fertil Steril, 2003, 79(3): 507-511.
28. Cacciatore B, Simberg N, Fusaro P, et al. Transvaginal Doppler study of uterine artery blood flow in in vitro fertilization-embryo transfer cycles. Fertil Steril, 1996, 66(1): 130-134.
29. 裴紅, 姜宏, 張文香, 等. 體外受精-胚胎移植中子宮內膜超聲參數與妊娠率的相關性. 生殖醫學雜志, 2009, 18(4): 390-392.
30. Schild RL, Knobloch C, Dorn C, et al. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril, 2001, 75(2): 361-366.
31. 唐志霞, 洪名云, 張玲, 等. 子宮動脈及子宮內膜血流對體外受精-胚胎移植結局的影響. 中國計劃生育和婦產科, 2015, 7(7): 15-17.
32. Sun Y, Huang J, Kong HF. Spontaneous rupture of unscarred uterus in the third trimester after in vitro fertilization-embryo transfer because of bilateral salpingectomy: A case report. Medicine (Baltimore), 2019, 98(48): e18182.
33. Shang J, Peng R, Zheng J, et al. The indicator of clinical outcomes for patients with heterotopic pregnancy following in-vitro fertilization with embryo transfer. Taiwan J Obstet Gynecol, 2019, 58(6): 827-832.

Chinese Journal of Evidence-Based Medicine

Ultrasound evaluation of endometrial receptivity to predict the clinical pregnancy outcome of IVF-ET: a meta-analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content