Three‐dimensional ultrasound diagnosis of adenomyosis is not associated with adverse pregnancy outcome following single thawed euploid blastocyst transfer: prospective cohort study

• DOI: 10.1002/uog.22065
• Publication Date: 2020-04-29T22:27:32Z
• Authors: S. Neal; S. Morin; M. Werner; N.‐A. Gueye; P. Pirtea; G. Patounakis; R. Scott; L. Goodman
• Keywords: Adenomyosis; Blastocyst Transfer; Live birth

The objectives of this study were (1) to assess the prevalence ultrasound (US) features adenomyosis in an infertile population undergoing in-vitro fertilization (IVF), (2) define inter- and intrarater agreement three-dimensional (3D) US assessment adenomyosis, (3) evaluate sonographic with respect pregnancy outcome following transfer a single thawed euploid blastocyst.This was prospective cohort study. Subjects scheduled undergo blastocyst between April December 2017 at large IVF center eligible for inclusion. Enrolled subjects underwent endometrial preparation frozen embryo transfer. 3D-US performed on day prior transfer, images stored subsequent evaluation. then blastocyst, outcomes collected. All volumes de-identified reviewed independently by five reproductive endocrinologists/infertility specialists expertise gynecological presence seven adenomyosis: global uterine enlargement, myometrial wall asymmetry, heterogeneous echogenicity, irregular junctional zone, cysts, fan-shaped shadowing ill-defined lesions. Adenomyosis considered be present if majority reviewers noted least one features. Inter- evaluated using Fleiss's kappa. Clinical cycle characteristics those without compared. primary interest live birth rate. Secondary included clinical rate miscarriage Logistic regression analysis account potential confounders.A total 648 included. 15.3% (99/648). On retrospective chart review, very few patients had symptoms. amongst independent conducting assessments poor (κ = 0.23) moderate 0.58), respectively. older (37.1 vs 35.9 years, P 0.02) more likely gonadotropin-releasing hormone agonist downregulation protocol when compared (12.1% 5.1%, 0.02). (80.0% 75.0%) (69.5% 66.5%) rates similar groups. When adjusting confounders, there no difference (adjusted odds ratio (aOR), 1.47 (95% CI, 0.85-2.56)), (aOR, 1.3 0.62-2.72)) or 1.28 0.78-2.08)) adenomyosis. No individual marker predictive outcome.The inter-rater is poor. Furthermore, markers asymptomatic may not associated altered blastocyst. These findings suggest that routine screening unselected patient warranted. © 2020 International Society Ultrasound Obstetrics Gynecology.