Relationship between Different Uterine Parameters on Three-Dimensional Ultrasound on the Day of Embryo Transfer and Pregnancy Outcome
Author(s): Elena Labarta, Giulia Mariani, Paula Celada, Ernesto Bosch
Research Question: To study if live birth rates are influenced by uterine size and/or presence of congenital uterine abnormalities (CUA) diagnosed by Three-dimensional ultrasound (3D-US) on the day of embryo transfer (ET). Design: A total of 244 oocyte recipients under hormonal replacement therapy for endometrial preparation were included and a 3D-US was performed before the blastocyst transfer. We analysed the relationship between type of uterus, endometrial thickness and volume, interostial distance (IOD) and transverse diameter (TD) with live birth rate (LBR). Results: 3D-US could be performed in 236 patients. In 16.5% of the cases a uterine anomaly, either congenital or acquired, was seen by the 3D-US but not previously diagnosed by 2D-US. Endometrial volume, thickness and TD were significantly higher in normal uterus than in CUA (p<0.05). LBR was 49.5% in normal uterus whereas it was 35.3% in CUA (p=0.14), with a miscarriage rate of 18.2% and 31.8%, respectively (p=0.12). In CUA, there was a significant relationship between the likelihood of live birth and endometrial volume (OR:2.76: 95%CI: 1.14-6.69), p=0.025. Conclusions: An unsuspected finding was present in 16.5% of the cases. CUA showed a significantly lower endometrial volume, thickness and TD when compared with normal uterus. There was a significant relationship between the likelihood of live birth and endometrial volume on the day of ET in patients with CUA, but not in normal uteri. Patients with CUA showed a decreased, albeit not significant, probability of live birth and an increase in the miscarriage rate.