Abstract
PurposeThis study aimed to evaluate the potential synergistic role of three-dimensional power Doppler angiography ultrasound and the expression of Leukemia Inhibitory factor (LIF) protein in predicting the endometrial receptivity of fresh In Vitro Fertilization (IVF) cycles. Materials and methods This prospective study involved 29 good prognosis women who underwent fresh IVF cycles with fresh blastocysts transfer. Serial measurements of sub-endometrial parameters via power Doppler angiography including vascularity index (VI), flow index (FI), and vascularization flow index (VFI) were conducted consecutively on the day of oocyte maturation trigger, ovum pick-up, and blastocyst transfer. Aspiration of endometrial secretion was performed on the day of embryo transfer. ResultsAfter performing multiple logistic regression analyses, the mean index of VI on the trigger day and LIF protein concentration at the window of implantation was significantly higher in clinically pregnant women than that of the non-pregnant women (p <0.05). The area under the curve (AUC) of LIF concentration was shown to have a powerful predictive value to forecast clinical pregnancy (0.884, p <0.05), with a cut-off value of 713 pg/mL. Likewise, VI index on the trigger day was adequate to become a predictor for the pregnancy event (AUC 0.803, the cut-off value >5.381, p<0.05). A combination of both variables utilizing the cut-off value was adequate for the differentiation of pregnant and non-pregnant cases (p <0.05). ConclusionVI index assessed on trigger day and the expression of LIF protein concentration at the window of implantation provided sufficient information to predict endometrial receptivity.
Assessment of endometrial receptivity by biomarkers
