Endometrial length Effect on ART outcome prediction- A crosses sectional study

Background and Aim : Background: Infertility is considered as a global public health issue which affectsalmost 186 million people worldwide.One of eight women and one of ten men at reproductive age, dealwith infertility. In spite of amount improvement in Assisted Reproductive Technology (ART), only lessthan 50% of patients success in terms of live-birth deliveries. A successful pregnancy outcome for patientsundergoing ART depends on several factors (such embryo quality, favorable intra uterine environment anda skillful IVF laboratory). One of important factor is the endometrial receptivity. There are several studiesabout predictive value of endometrial characteristics in success of ART such echopatern and endometrialthickness. But in women without uterine abnormalities, little is known about uterine and endometrial length.Aime: The purpose of this study was determining the relationship between endometrial length and positivepregnancy test in ART patients.Methods : It was a cross sectional study that included patients who have been referred for IVF/ICSI therapyfrom 2013 to 2016. All nulliparous women with inclusion criteria, aged 20–38 years old presented forultrasound measurement prior to fresh embryo transfer. Endometrial length was measured usingtransvaginal ultrasound with Medison Accuvix device on the day of hCG administration. . The relationshipbetween endometrial length and treatment success assessed. Independent Sample T-test, ROC curve andthe AUC curve index and Chi-Square Test were used. P value <0.05 was statistically significant.Results : There was a significant relationship between endometrial length (41.5%) and treatment success(P <0.05). The value of 41.5 with sensitivity 66.7%, specificity 50.6%, Positive Predictive Value 46.8%,Negative Predictive Value 69.4% and Efficiency 56.62% can be used as a proper cutoff point with an areaunder curve of 0.63. Combined uterine Indexes cut off point and profile for ART success such as thickness,echopatern, position and length may improve the ART outcome, so more study in this regard isrecommended.Conclusion : The value of 41.5 for endometrial length with appropriate sensitivity, specificity, PositivePredictive Value, Negative Predictive Value and Efficiency can be used as a proper cutoff point forprediction of higher ART success rate. We recommend TVS as the first step of uterine and endometriumreceptivity assessment in ART cycle.

کلیدواژه ها:

ART ، Ultrasonography ، endometrial length