3D ultrasound assessment of endometrial junctional zone anatomy as a predictor of the outcome of ICSI cycles

Ahmed M. Maged, Abdel Maguid Ramzy, Mona Aboul Ghar, Hossam El Shenoufy, Sherine H. Gad Allah, Amr Wahba, AbdAllah Y. ElKateb, Noha Hwedi
In: European Journal of Obstetrics & Gynecology and Reproductive Biology · 2017 · vol. 212 , pp. 160–165 · doi:10.1016/j.ejogrb.2017.03.035 · PMID:28376433 · W2598481365
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This study utilized 3D ultrasound to assess the endometrial junctional zone's anatomy and determine its predictive value for the success of intracytoplasmic sperm injection (ICSI) cycles.

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Abstract

ObjectiveTo study the relation between junctional zone thickness (JZ) and success of implantation in IVF/ICSI cycles.Study designA prospective study included 100 infertility patients undergoing ICSI. The long protocol was used in all patients. JZ was measured using 3D ultrasound, in the coronal section, at three places, on two occasions. First measurement was done before HMG was started (i.e. when down regulation was achieved). Second measurement was done on the day of ovum pick up (OPU). Follow up after treatment was done to determine the rate of implantation.ResultsThere was a highly significant difference between pregnant and non pregnant treated women regarding the measurement of JZ at the day of OPU at all sites named fundal (0.27±0.1 vs. 0.38±0.14), anterior (0.28±0.07 vs. 0.36±0.09), posterior (0.32±0.1 vs. 0.37±0.09) and average (0.29±0.08 vs. 0.37±0.09) respectively. The cut off value, sensitivity and specificity of measurement of JZ at fundus were (≤0.31,90% and 66.7%), at anterior wall were (≤0.35,90% and 60%), at posterior wall (≤0.25, 50% and 93.3%) and average were (≤0.32,70% and 70%) respectively.ConclusionThe thinner the junctional zone at day of OPU, the higher the implantation rate and the difference between JZ measured at the day of down regulation and the day of OPU is a predictor of the outcome of ICSI cycles.

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