जर्नल ऑफ़ फर्टिलाइजेशन: इन विट्रो - आईवीएफ-वर्ल्डवाइड, रिप्रोडक्टिव मेडिसिन, जेनेटिक्स और स्टेम सेल बायोल
खुला एक्सेस

अमूर्त

Ultrasound Based Endometrial Receptivity Scoring Improves In Vitro Fertilization Pregnancy Rates

Hannah E. Pierson, Ken Cadesky, Jim Meriano, Jesse Invik, Carl A. Laskin, Roger A. Pierson*

Background: The endometrium is a key factor in establishment of pregnancy. In IVF therapy, endometrial investigation is generally limited to thickness measurements or occasionally invasive biopsy-based procedures. A non-invasive endometrial receptivity diagnostic (usER test; Matris™, Synergyne Imaging Technologies Inc., Canada.) has recently become available. We performed a retrospective chart review study to test the hypothesis that routine implementation of the ultrasound- based endometrial receptivity (usER) diagnostic test would improve pregnancy rates in IVF cycles. Methods: All patients undergoing IVF at one Canadian reproductive medicine clinic in the 2018 calendar year were considered (n=1521). Patients received either standard of care endometrial thickness and pattern assessments (n=1205) or diagnostic usER testing (n=316) prior to planned embryo transfer. In the usER group, patients with usER scores of 7.0 or above proceeded to embryo transfer (ET; n=246); patients with scores <6.5 (n=70) had their planned embryo transfer deferred and embryos cryopreserved, or retained in cryopreservation, for use in future cycles. Pregnancy (positive beta-hCG) rates were calculated for fresh, frozen-thaw, and aggregate (combined fresh and frozen) ET cycles. Results: Aggregate pregnancy rates for the usER group were 12% higher than for the Standard of Care group (p=0.0005; 52.0% versus 40.0% respectively). The pregnancy rate for fresh embryo transfer cycles in the usER group was 20.0% higher than that of the Standard of Care group (p=0.0005; 54.9% versus 34.9%, respectively). In frozen embryo transfer cycles, a 9.4% higher pregnancy rate was observed in the usER group than the Standard of Care group (p=0.017; 51.3% versus 41.9% respectively). Implementation of usER resulted in conservation of 64 cryopreserved embryos through deferral of low-probability of pregnancy cycles. Discussion & Context: This ‘real world’/‘all patients’ retrospective analysis demonstrates that usER testing may be implemented to improve pregnancy rates and conserve embryo potential.