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| Predictive value of endometrial-myometrial junction index measured by three-dimensional vaginal ultrasound for the pregnancy outcomes of women with adenomyosis after assisted reproduction |
| 1. The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, 210000；2. Jiangbei Branch, Zhongda Hospital Affiliated to Southeast University, Nanjing |
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Abstract To investigate the predictive value of endometrial-myometrial junction index measured by three-dimensional transvaginal ultrasound (3D-TVUS) for the pregnancy outcomes of women with adenomyosis after assisted reproduction. Methods: 292 women with adenomyosis who had been assisted reproduction were selected and were divided into group A (women with pregnancy) and group B (women without pregnancy) acceding to the pregnant situation from June 2020 to February 2022. The general data, the endometrial-myometrial junction indexes, such as the endometrial thickness and morphology measured by 3DTVUS on the day of HCG injection of the women were compared between the two groups. Binary logistic regression analysis was used to explore the influencing factors of pregnancy failure of the women with adenomyosis. Receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of the endometrial-myometrial junction indexes measured by 3D-TVUS of the women with adenomyosis on their pregnancy outcomes after assisted reproduction. Results: In 292 women who had been given IVF/ICSI-ET, there were 122 (41.8%) women with clinical pregnancy in group A, and 170 (58.2%) women without clinical pregnancy in group B. The thickness (8.6±2.2 mm) of endometrium-myometrial junction measured by 3D-TVUS and the abnormal rate of endometrial shape (55.3%) of the women in group B were significantly higher than those (5.2±1.8 mm and 24.6%) of the women in group A (all P<0.05). Regression analysis showed that the advanced age, the increased thickness of endometrio-myometrial junction area, and the abnormal endometrial shape were the independent factors of the pregnancy failure of the women with adenomyosis (P<0.05). Both the thickness and shape of the endometrium- myometrial junction area of the women with adenomyosis had certain predictive values for their pregnancy outcomes after assisted reproduction. The area under the curve, the sensitivity, and the specificity of the combined of the thickness and shape of the endometrium-myometrium junction area of the women with adenomyosis for their pregnancy outcomes were 0.896, 81.8%, and 84.4%, respectively. Conclusion: The endometrial-myometrial junction indexes measured by 3D-TVUS of the women with adenomyosis can well predict their pregnancy outcomes. The increases thickness and the abnormal shape of the endometrial-myometrial junction area of the women with adenomyosis can increase their pregnancy failure rate after assisted reproductive.
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