Prediction of clinical pregnancy in in-vitro fertilization-embryo transfer by transvaginal three-dimensional ultrasonography and serum hormone levels.

Abstract

This study aimed to explore the predictive value of transvaginal three-dimensional ultrasonography combined with serum progesterone and estrogen levels in in-vitro fertilization-embryo transfer. A total of 100 patients undergoing frozen-thawed embryo cycles were investigated. On the day before embryo transfer, two-dimensional ultrasound was used to assess endometrial thickness and blood flow parameters, including the resistance index, pulsatility index, and systolic/diastolic velocity ratio. These measurements were then transitioned to three-dimensional ultrasound, where endometrial volume, flow index, vascularization flow index, and sub endometrial vascularization index were evaluated. On the day of embryo transfer, serum progesterone and estradiol levels were measured. Based on pregnancy outcomes, patients were divided into pregnant and non-pregnant groups. The results showed no significant differences between the groups in terms of endometrial thickness or two-dimensional ultrasound parameters (P>0.05). However, the pregnant group had significantly higher endometrial volume and sub-endometrial vascularization parameters (P<0.05). The combined predictive value of endometrial volume and serum estrogen was 0.735, with sensitivity of 77.3% and specificity of 90.7%. These findings suggest that three-dimensional ultrasonography, in conjunction with serum estrogen levels, can accurately predict clinical pregnancy outcomes in IVF-ET.