Journal of Fertilization: In Vitro - IVF-Worldwide, Reproductive Medicine, Genetics & Stem Cell Biol
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Ultrasound Based Endometrial Receptivity Scoring Improves In Vitro Fertilization Pregnancy Rates

Hannah E. Pierson, Ken Cadesky, Jim Meriano, Jesse Invik, Carl A. Laskin, Roger A. Pierson*

Background: The endometrium is a key factor in establishment of pregnancy. In IVF therapy, endometrial investigation is generally limited to thickness measurements or occasionally invasive biopsy-based procedures. A non-invasive endometrial receptivity diagnostic (usER test; Matris™, Synergyne Imaging Technologies Inc., Canada.) has recently become available. We performed a retrospective chart review study to test the hypothesis that routine implementation of the ultrasound- based endometrial receptivity (usER) diagnostic test would improve pregnancy rates in IVF cycles. Methods: All patients undergoing IVF at one Canadian reproductive medicine clinic in the 2018 calendar year were considered (n=1521). Patients received either standard of care endometrial thickness and pattern assessments (n=1205) or diagnostic usER testing (n=316) prior to planned embryo transfer. In the usER group, patients with usER scores of 7.0 or above proceeded to embryo transfer (ET; n=246); patients with scores <6.5 (n=70) had their planned embryo transfer deferred and embryos cryopreserved, or retained in cryopreservation, for use in future cycles. Pregnancy (positive beta-hCG) rates were calculated for fresh, frozen-thaw, and aggregate (combined fresh and frozen) ET cycles. Results: Aggregate pregnancy rates for the usER group were 12% higher than for the Standard of Care group (p=0.0005; 52.0% versus 40.0% respectively). The pregnancy rate for fresh embryo transfer cycles in the usER group was 20.0% higher than that of the Standard of Care group (p=0.0005; 54.9% versus 34.9%, respectively). In frozen embryo transfer cycles, a 9.4% higher pregnancy rate was observed in the usER group than the Standard of Care group (p=0.017; 51.3% versus 41.9% respectively). Implementation of usER resulted in conservation of 64 cryopreserved embryos through deferral of low-probability of pregnancy cycles. Discussion & Context: This ‘real world’/‘all patients’ retrospective analysis demonstrates that usER testing may be implemented to improve pregnancy rates and conserve embryo potential.