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. 2018 Oct;97(41):e12764.
doi: 10.1097/MD.0000000000012764.

Three-dimensional scan of the uterine cavity of infertile women before assisted reproductive technology use

Liana Pleş  1 , Cătălina Alexandrescu  2 , Cringu Antoniu Ionescu  3 , Cristian Andrei Arvătescu  4 , Simona Vladareanu  5 , Marius Alexandru Moga  4
Affiliations

Three-dimensional scan of the uterine cavity of infertile women before assisted reproductive technology use

Liana Pleş et al. Medicine (Baltimore). 2018 Oct.

Abstract

The primary objective was to assess the utility of routine 3-dimensional (3D) ultrasound in the evaluation of infertile women and to estimate the prevalence of uterine anomalies before the use of assisted reproductive technology (ART), using the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy classification system. A second objective was to assess the effect of uterine anomalies on the pregnancy rate in patients who underwent assisted reproductive techniques.We retrospectively studied 668 patients treated in the Department Obstetrics Gynecology and Neonatology "Sf Ioan" Clinical Emergency Hospital and in the Department of Medical and Surgical Specialties, Faculty of Medicine "'Transilvania" University of Brasov between July 2016 and February 2017 for subfertility. Patients were examined using 2-dimensional (2D) and 3-dimensional (3D) transvaginal ultrasound. Müllerian duct anomalies were present in 6.13% of patients, with the most common anomaly being a dysmorphic uterus (class U1c in 42.68% of patients), 17 patients (20.73%) with incompletely septate uterus (class U2a), 12 patients (14.63%) with a completely septate uterus (classU2b), 8 patients (9.75%) with a partly bicorporeal uterus (classU3a), and 6 patients (7.31%) with a completely bicorporeal uterus (class U3b). Only 1 (1.21%) patient had an aplastic uterus without a rudimentary cavity (class U5b). The pregnancy rate in the presence of uterine anomalies was 55% and the pregnancy rate in control group patients was 39.8%. The incidence of pregnancy in the group with uterine anomalies was statistically similar with the control group of normal uterus (P < .11). For ongoing pregnancy rate and live birth rate, our data indicated a slightly elevated rate for both of those indexes in the anomalies group. The incidence of miscarriage in the presence of uterine anomalies was 24% and 6.7% in the control group, which is statistically significant (P = .05).3D ultrasound evaluation of the uterus should be considered before ART in order to make an accurate diagnosis of the uterine congenital anomaly and improve ART results.

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Conflict of interest statement

The authors have nothing to disclose and no conflicts of interest.

Figures

Figure 1
Figure 1
Three-dimensional multiplanar ultrasound image of normal uterus U0 in sectional planes.
Figure 2
Figure 2
(A) Three-dimensional ultrasound images in coronal plane of U2 septate uterus. (B) Three-dimensional ultrasound images in coronal plane of U2 septate uterus with pregnancy.
Figure 3
Figure 3
Three-dimensional ultrasound images in multiplanar planes of U2a partial septate uterus.
Figure 4
Figure 4
Three-dimensional ultrasound images in coronal plane of U1a dysmorphic uterus, T-shaped cavity.
Figure 5
Figure 5
Three-dimensional ultrasound images in coronal plane of U2a uterine partial septate uterus.
Figure 6
Figure 6
Three-dimensional ultrasound images in coronal plane of U3b complete bicorporeal uterus; note the complete separated uterine cavities and lack of Müllerian fusion.
Figure 7
Figure 7
Three-dimensional ultrasound images in coronal plane of U4b hemiuterus.
See this image and copyright information in PMC

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