Browsing by Author "Martins, Renato Alessandre Silva"
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- Assessment of Endometrial Receptivity in Assisted Reproductive Cycles: The Value of Biophysical MarkersPublication . Martins, Renato Alessandre Silva; Oliveira, José António Martinez Souto de; Oliani, António HélioObjective: Human implantation is a complex process requiring synchrony between a healthy embryo and a functionally competent or receptive endometrium. We evaluated the potential role of serial biophysical and biochemical parameters to predict endometrial receptivity in Assisted Reproductive Technology (ART) cycles. Design: Endometrial receptivity assessment protocol to predict clinical pregnancy with serial sequential biochemical (serum estradiol) and biophysical (endometrial volume and adjusted endometrial volume, uterine artery fluxometry and fluxometry of subendometrial flow) parameters was designed. All parameters were compared between negative and positive outcome for clinical pregnancy. Serial serum estradiol and 2D and 3D-transvaginal ultrasound and Doppler fluxometry were performed in a prospective cohort study of 169 subjects. Results: No statistical difference was noted between case and controls, in terms of demographics and ART procedures and scores. Endometrial volume and adjusted endometrial volume were significantly higher in the positive group as soon as day 6 of ovarian controlled stimulation. Serum estradiol was significantly higher in the positive group from day 8 after ovarian controlled stimulation. Uterine artery resistance and pulsatility index showed statistical difference between the two groups. Also, statistical significance was obtained between the two groups in terms of subendometrial vascularization. Conclusions: Serial endometrial volumetry assessment and serial endometrial doppler fluxometry provides a predictive clinical tool enhancing elective embryo transfers in fresh ART cycle. Continuous serum estradiol and 3D endometrial volume and adjusted endometrial volumes may reflect endometrial changes during ART procedures.