The readiness of the endometrium for extracorporeal fertilization: prognosis by the data of ultrasound and morphological study

Predicting the outcome of in vitro fertilization is of great importance when deciding on the use of this method. The purpose of the study was to determine the echographic and morphological criteria for the readiness of the endometrium for implantation to increase the effectiveness of IVF. The case-control method was used to select and examine 250 women, divided into 3 groups: group 1 (main group, IVF 1, n=87) included infertile women planning IVF for the first time, group 2 (comparison group, IVF 2, n=83) - women with unsuccessful previous IVF attempts; in group 3 (control group, n=80) - women with a history of physiological pregnancy that successfully ended in natural childbirth. An ultrasound examination of the pelvic organs and morphological examination of the biopsy of the uterine mucosa in a significant part of women from the IVF 1 and IVF 2 groups revealed signs of chronic endometritis, which is the cause of infertility. According to 2D echography and Doppler ultrasound data, the echographic criteria for the readiness of the endometrium for IVF are determined: the thickness of the endometrium is more than 8 mm, the correspondence of the endometrial echostructure to the phase of the menstrual cycle, the uniformity of the M-echo, the absence of hyper- and hypoechoic inclusions, and the absence of hemodynamic disturbances in the uterine vessels and in the vascular basin of the pelvis in the second phase of the menstrual cycle. The morphological criteria of the readiness of the endometrium for implantation, in our opinion, include the absence of inflammatory changes in the endometrium (focal and diffuse lymphoid cell infiltrates, plasma cells in the stroma), as well as sclerotic changes in the walls of the spiral arteries. Under these conditions, the prognosis of the effectiveness of the IVF program is favorable.