Relationship between Transvaginal Ultrasound Endometrial Volume, Body Mass Index and Endometrial Pathology in Women with Postmenopausal Bleeding

Background Menopause is recognized to have occurred after one year of amenorrhea, for which there is no other obvious pathological or physiological cause. Perimenopause should include the period immediately prior to the menopause (when the endocrinological, biological and clinical features of approaching menopause commence) and the first one year after menopause. Objectives The aim of the study is classification of patients into those with benign endometrial pathology and those with endometrial hyperplasia or carcinoma using endometrial volume and BMI. Patients and Methods This observational cross sectional study was conducted at the Department of Obstetrics and Gynecology in Ain Shams University Hospital from March 2019 till January 2020. The population of this study was 100 menopausal women with postmenopausal bleeding ≥12 months and endometrial thickness by TVUS ≥5 mm. Results According to histopathology of endometrial carcinoma, statistical analysis of our data revealed that age, menopausal duration and BMI were significantly highest. Parity was significantly lowest. Endometrial volume was significantly highest in carcinoma (7.9±2.9 cc). Age, menopausal duration, parity and endometrial volume had significant moderate diagnostic performance in predicting endometrial carcinoma but BMI had significantly low. Age ≥ 62.0, menopausal duration ≥ 11.0 and parity ≤3.0 had low diagnostic characteristics in diagnosis of endometrial carcinoma but endometrial volume ≥ 6.0 had high sensitivity but low other diagnostic characteristics in the diagnosis of endometrial carcinoma. According to histopathology of endometrial hyperplasia, statistical analysis of our data revealed that age, menopausal duration, BMI, parity and endometrial volume had no significant diagnostic performance in the diagnosis of endometrial hyperplasia. Conclusion In our study, analysis of data revealed that the using of transvaginal measurement of endometrial volume is the best predictor of endometrial cancer with a positive correlation with BMI.

Effectiveness the perfusion of Endometrial and Subendometrial and Endometrial volume on the endometrial receptivity of FET Cycles

Objective: this study was effects of endometrial and subendometrial blood perfusion and endometrial volume on endometrial receptivity in frozen embryo transfer (FET) cycles. Materials and methods: This prospective observational cohort study, that on infertile women who referred for FET to Shariati Hospital and Omid Infertility Clinic in Tehran (Iran) .112 patients selected among eligible women with good quality embryos. After homogenization, participants underwent endometrial preparation for hormone replacement therapy (HRT) according to a similar routine protocol. On the day of the FET, they underwent a thorough ultrasound examination for possible effective parameters. Subsequently, one to two good quality blastocysts were transferred, and the pregnancy outcomes were monitored. Results: In vitro fertilization (IVF) was performed on 112 patients with a mean age of 33.93±4.93 years. Although, serum β-HCG level was used to confirm pregnancy. Accordingly, out of 112 participating patients, 50 (44.6%) became pregnant after IVF. Based on the results of this study, the endometrial blood flow was significantly different between the two groups of pregnant and non-pregnant women, so that a higher pregnancy rate was observed in participants with multi-focal and spare endometrial blood flows (P<0.05). Additionally, a significant relationship between endometrial blood flow and pregnancy outcome so that there was more ongoing pregnancy rates in those with multi-focal and spare endometrial blood flows (P<0.05). But the endometrial variables of volume, length, width, thickness and pattern were not significantly different between the two groups of pregnant and non-pregnant women. Moreover, contextual parameters had no significant relationship with pregnancy outcome (P>0.05). Endometrial measurement indices were also ineffective on pregnancy outcomes and no significant difference was there between the groups (P>0.05). Conclusion: Collectively, the endometrial blood flow can play an effective role in improving pregnancy event and its stability after IVF, but the endometrial volume was unable to predict pregnancy event and its stability after IVF.

The use of hysteroscopic metroplasty with diode laser to increase endometrial volume in women with septate uterus: preliminary results

Background Septate uterus is a common Mullerian ducts anomaly. The aim of our pilot study was the evaluation of diode laser hysteroscopic metroplasty efficacy to increase endometrial volume in women with septate uterus. Results We prospectively enrolled 10 consecutive patients with septate uterus undergoing office hysteroscopic metroplasty with diode laser between February and November 2019. Endometrial volume was evaluated before and 3 months after surgery using 3D transvaginal ultrasound. The surgical procedure was uncomplicated in all patients, the endometrial volume increased at 3 months follow-up (the median increase was 1.9 cm3 (range 1.7–2.1), and there was a complete removal of septum with no intrauterine synechiae at follow-up hysteroscopy. Conclusions Office hysteroscopic metroplasty with diode laser is a safe procedure and has preliminary showed to increase endometrial volume. The increase in endometrial volume by 3D-TV US could be used as a prognostic factor for the reproductive outcomes.

The predictive value of serial serum estradiol and serial endometrial volume on endometrial receptivity on assisted reproductive technology cycles

Background Diagnosis of endometrial receptivity is still unclear and conflicting. Despite advances in embryo development during assisted reproductive technologies (ART) cycles, the intricate process of implantation is still matter for debate and research. Materials and methods Prospective case control of 169 subjects during ovarian controlled stimulation for ART. Endometrial receptivity assessment to predict clinical pregnancy with serial continuous biochemical (serum estradiol) and biophysical (endometrial volume and adjusted endometrial volume) parameters were used. Both parameters were compared between negative and positive outcome in terms of clinical pregnancy. Results No statistical difference was noted between the two groups in terms of demographics and ART procedures and scores. Serum estradiol was significantly higher in the positive group from day 8 after ovarian controlled stimulation. Endometrial volume and adjusted endometrial volume were significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation. Conclusions Continuous serum estradiol and 3D endometrial volume and adjusted endometrial volumes may reflect endometrial changes during ART procedures and provide a useful real time tool for clinicians in predicting endometrial receptivity.

Endometrial Receptivity on Assisted Reproductive Technology Cycles – a correlation between Serial Serum Estradiol levels and Serial Endometrial Volume Assessment

Background: Diagnosis of endometrial receptivity is still unclear and conflicting. Despite advances in embryo development during assisted reproductive technologies (ART) cycles, the intricate process of implantation is still matter for debate and research. Materials and Methods: Serial serum estradiol levels and 3D transvaginal ultrasound performed in women on ART cycle to evaluate a pattern that better predicts implantation rates. 169 subjects on a prospective case control study were assessed. Serial biochemical and biophysical parameters were assessed during ovarian controlled stimulation and results compared in terms of pregnancy outcome.Results: No statistical difference was noted between the two groups in terms of demographics and ART procedures and scores. Serum estradiol was significantly higher in the positive group from day 8 after ovarian controlled stimulation. Endometrial volume and adjusted endometrial volume were significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation. Conclusions: Continuous serum estradiol and 3D endometrial volume and adjusted endometrial volumes may reflect endometrial changes during ART procedures and provide a useful real time tool for clinicians in predicting endometrial receptivity.