Endometrial Volume and Sub-endometrial Vascularity as Predictors of In-vitro Fertilization Success
Condition: Reproductive Techniques, Assisted
Study type: Observational

Summary: 
      100 patients aged 21-40 years old, diagnosed as primary or secondary infertility These
      patients are then assigned to receive ICSI treatment (ovulation induction, . They undergo a
      3D vaginal ultrasound before treatment to measure the junctional zone thickness and followed
      up after treatment to determine the rate of implantation.

      Intervention(s) All patients will undergo 3D ultrasound to measure the thickness of the
      junctional zone at day 21 of the cycle.
    

Detailed description: 
      100 patients aged 21-40 years old, diagnosed as primary or secondary infertility due to the
      following causes of infertility; ( Pelvic Inflammatory disease, dysovulation , tubal
      infertility, unexplained infertility, combined infertility or due to male factor ). These
      patients are then assigned to receive fertility treatment (ICSI) They undergo a 3D vaginal
      ultrasound before treatment to measure the junctional zone thickness and followed up after
      treatment to determine the rate of implantation.

      Intervention(s) All patients will undergo 3D ultrasound to measure the thickness of the
      junctional zone at day 21 of the cycle.
    

Intervention name(s): 3 D ultrasound and Doppler examination; GnRH agonist
Intervention type(s): Other; Drug
Intervention description(s): Endometrial thickness was measured in the longitudinal plane at the widest anteroposterior diameter with a trans-vaginal 2D ultrasound, and then 3D mode was then activated with power Doppler setting for this study standardized using a frequency at 4-9 MHZ pulse repetition frequency at 0.5KHz gain at-3.0 and wall motion filter at 1. The sub-endometrial region was considered to be within 3 mm of the originally defined myometrial-endometrial contour. The endometrial volume (EV) and 3D power Doppler indices below the endometrium were measured using the automated VOCAL™ for the 3D power Doppler histogram analysis; All women received daily subcutaneous 0.1 mg triptorelin injection started from day 21) of the cycle preceding stimulation. Downregulation of the pituitary gonadotropins was confirmed after 12 days , gonadotropin (Gn) induction was started using Human menopausal gonadotropins for ovarian stimulation. The starting dose was 225 to 300 IU . Ultrasound Folliculometry was done every other day . When two or more follicles reached a minimum mean diameter of 18 mm, triggering of ovulation trigger was done using Human chorionic gonadotropin (hCG) 10,000 IU and ovum pick up was scheduled 36 hours later
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        women with primary or secondary infertility and were scheduled for a first IVF/ICSI
        treatment cycle due to Pelvic Inflammatory disease, ovulatory dysfunction, tubal
        infertility, unexplained infertility , combined infertility with normal transvaginal
        ultrasound.
      
Keywords: junctional zone; Implantation; Intracytoplasmic sperm injection