BACKGROUND There is much value in identifying non-invasive ways of measuring endometrial receptivity, as it has the potential to improve outcomes following in vitro fertilization (IVF). It has been suggested that endometrial echogenicity on the day of hCG administration was a good marker of endometrial receptivity. In the daily practice, we notice that patients with non-homogeneous hyperechoic endometrium on the embryo transfer day usually have lower pregnancy rates. We therefore extended the research onward transformation of echo pattern after hCG trigger to analyze the relationship between endometrial echogenicity transformation and IVF outcomes. METHODS A total of 146 infertile women undergoing their first IVF cycle were recruited in the prospective cohort study from August 2017 through August 2018. A series of endometrial echo pattern monitoring was carried out in these patients after hCG trigger: hCG day, from 1 through 3 days after ovum pick-up (OPU + 1, OPU + 2, OPU + 3). RESULTS The endometrial echogenicity value was calculated as the ratio of the hyperechogenic endometrial area over the whole endometrial area. Clinical pregnancy rate and embryo implantation rate had positive relationship with echogenicity value. The ROC curve analysis of endometrial echogenicity showed the area under curve was greatest on the second day after oocyte retrieval (OPU + 1, 2, 3 were 0.738, 0.765, 0.714 respectively) versus pregnancy. Endometrial echogenicity value on OPU + 2 had a higher predictive efficiency, and the cutoff value was 76.5%. The sensitivity was 61.3% and specificity was 82.0%. When putting the cut-off at <60%, the sensitivity was 93.8% and the specificity was 23.1%. CONCLUSIONS The endometrial echogenicity value on OPU + 2 was recommended to evaluate endometrial receptivity. It seemed appropriate for clinicians to provide a 'freeze all' IVF cycle and transfer in a subsequent frozen-thawed embryos cycle when echogenicity value <60% on OPU + 2. TRIAL REGISTRATION The registration number was ChiCTR-OOC-17012214 and the registration date was August 1st, 2017.

中文翻译：

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hCG触发后子宫内膜回声模式转换在预测IVF妊娠结局中的价值：一项前瞻性队列研究。

背景技术在确定测量子宫内膜容受性的非侵入性方法方面，具有很大的价值，因为它有可能改善体外受精（IVF）后的结局。已经提出，hCG给药当天的子宫内膜回声是子宫内膜接受性的良好标志。在日常实践中，我们注意到在胚胎移植当天患有非均质性高回声子宫内膜的患者通常有较低的怀孕率。因此，我们扩展了hCG触发后回声模式的向前转换研究，以分析子宫内膜回声转换与IVF结果之间的关系。方法在2017年8月至2018年8月的前瞻性队列研究中，共招募了146名经历第一个IVF周期的不育女性。在hCG触发后，对这些患者进行了一系列子宫内膜回声模式监测：hCG日，卵子拾起后1至3天（OPU + 1，OPU + 2，OPU + 3）。结果子宫内膜回声值计算为高回声性子宫内膜面积与整个子宫内膜面积之比。临床妊娠率和胚胎着床率与回声值呈正相关。子宫内膜回声性的ROC曲线分析显示，在取卵后第二天，曲线下的面积相对于妊娠最大（OPU +，1、2、3分别为0.738、0.765、0.714）。OPU + 2的子宫内膜回声值具有较高的预测效率，截止值为76.5％。敏感性为61.3％，特异性为82.0％。当截止值小于60％时，灵敏度为93。8％，特异性为23.1％。结论建议使用OPU + 2上的子宫内膜回声值来评估子宫内膜的接受性。当在OPU + 2上的回声值<60％时，临床医生似乎应该提供“全部冻结” IVF周期并在随后的冻融胚胎周期中转移。试用注册该注册号为ChiCTR-OOC-17012214，注册日期是2017年8月1日。