Three-dimensional ultrasound diagnosis of T-shaped uterus is associated with adverse pregnancy outcomes after embryo transfer. Issue 5 (November 2019)

• Record Type: Journal Article
• Authors: Neal, Shelby A.; Morin, Scott J.; Werner, Marie D.; Gueye, Ndeye-Aicha; Pirtea, Paul; Scott, Richard T.; Goodman, Linnea R.
• Is Part Of: Reproductive biomedicine online. Volume 39:Issue 5(2019)
• Page Start: 777
• Page End: 783
• Publication Date: 2019-11
• Subjects: Frozen embryo transfer -- In vitro fertilization -- Live birth -- Miscarriage -- Three-dimensional ultrasound -- T-shaped uterus; Human reproductive technology -- Periodicals; Human embryo -- Periodicals; Reproduction -- Periodicals; 616.692
• DOI: 10.1016/j.rbmo.2019.07.030
• Languages: English
• ISSNs: 1472-6483

Abstract

Abstract: Research question: Is T-shaped uterine cavity morphology associated with adverse pregnancy outcomes after transfer of a single thawed euploid blastocyst? Design: In this secondary analysis of a prospective cohort study, 648 patients with three-dimensional ultrasound (3D-US) data obtained on the day before embryo transfer were categorized into three groups according to uterine cavity morphology: normal ( n = 472), intermediate ( n = 166) and T-shaped ( n = 10). Quantitative uterine cavity dimensions were used to evaluate uterine cavity morphology. Pregnancy outcomes, including live birth, clinical miscarriage and ectopic pregnancy, were compared among the groups. Results: The prevalence of a T-shaped uterus in this cohort was 1.5%. Uterine cavity morphology was strongly associated with the ratio of interostial distance and isthmic diameter ( P < 0.01). Live birth rates were 66.5% for normal, 65.7% for intermediate and 40.0% for T-shaped cavity morphology. Women with a T-shaped uterus had an increased risk of clinical miscarriage (40.0% versus 7.0% for normal and 9.0% for intermediate cavity morphology, P < 0.01) and ectopic pregnancy (10.0% versus 1.1% for normal and 1.9% for intermediate cavity morphology, P = 0.05). When evaluating interostial distance and isthmic diameter ratio to determine pregnancy outcomes, a cut-off value of 2 was noted to have weak predictive value for live birth, but not clinical miscarriage or ectopic pregnancy. Conclusions: T-shaped uterine cavity morphology is associated with adverse pregnancy outcomes after transfer of a single thawed euploid blastocyst. Given the low prevalence of this condition, quantifying the magnitude of risk will require a larger cohort of patients.