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Insights into Imaging
Published in: Insights into Imaging 1/2024

Open Access 01-12-2024 | Infertility | Original Article

Evaluation of endometrial receptivity in women with unexplained infertility by shear wave elastography

Authors: Zheng-ying Li, Lu Cai, Zhi-jun Zhang, Hai-rong Zou, Mei He, Mei-lin Qin, Hui Wang

Published in: Insights into Imaging | Issue 1/2024

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Abstract

Objectives

The endometrium of most unexplained infertility (UI) patients has been altered histologically. Shear wave elastography (SWE) is utilized to assess the signature of living tissue. This study aimed to explore the value of SWE in evaluating endometrial receptivity (ER) in UI patients.

Methods

In total, 59 UI patients (UI group) and 52 normal control women (NC group) who received fertility consultation in our hospital were included between January 2022 and June 2023. We divided them into the late-proliferative phase of UI group (LPUI; n = 59), mid-secretory phase of UI group (MPUI; n = 41), late-proliferative phase of NC group (LPNC; n = 52), and mid-secretory phase of NC group (MPNC; n = 45). Transvaginal ultrasonography and SWE were performed during the LP and MP. Endometrial thickness (EMT), uterine artery pulsatility index (UA-PI), endometrial mean elasticity (E-mean), and mean shear wave velocities (SWV-mean) were measured.

Results

There were significant differences in E-mean, SWV-mean, EMT, and UA-PI between the UI group and the NC group during both the LP and MP (p MPNC vs MPUI < 0.05, p LPNC vs LPUI < 0.05). E-mean and SWV-mean decreased with increasing EMT but increased with increasing UA-PI (p < 0.05). The most effective parameter for evaluating ER in UI patients is the E-mean (AUC = 0.89).

Conclusions

UI patients exhibited thinner endometrium, increased endometrial stiffness, and poor endometrial blood perfusion. E-mean was the most effective parameter to evaluate ER in UI patients. The study preliminarily proved that SWE is a promising non-invasive tool for evaluating the condition of endometrium.

Critical relevance statement

This study aimed to explore the significance of endometrial elasticity measured by SWE in evaluating patients with UI. The findings revealed a correlation between EMT, UA-PI, and E-mean. Endometrial elasticity can serve as an effective indicator for predicting ER.

Key points

1. To explore the significance of endometrial elasticity in assessing patients with UI.
2. The endometrium of UI patient exhibited thinness, stiffness, and poor blood perfusion.
3. Endometrial elasticity serves as a valuable indicator for evaluating endometrial receptivity.

Graphical Abstract

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Metadata
Title
Evaluation of endometrial receptivity in women with unexplained infertility by shear wave elastography
Authors
Zheng-ying Li
Lu Cai
Zhi-jun Zhang
Hai-rong Zou
Mei He
Mei-lin Qin
Hui Wang
Publication date
01-12-2024
Publisher
Springer Vienna
Published in
Insights into Imaging / Issue 1/2024
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-024-01646-3

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