Author(s)

Mamadou Dembélé^1,2*, Alassane Kouma¹, Ilias Guindo¹, Souleymane Sanogo¹, Zoumana Cheick Berete³, Ousmane Traoré¹, Mamadou N’Diaye¹, Brahima Doumbia¹, Oncoumba Diarra¹, Issa Cissé¹, Aboubacar Sidiki N’diaye¹, Bandiougou Doucouré², Youssouf Yalcouyé², Adama Diaman Keita¹, Siaka Sidibe¹

¹Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS), Bamako, Mali.
²Medical Imaging Department, Kati University Hospital, Kati, Mali.
³Department of Education and Research in Public Health (DERSP), Bamako, Mali.

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p < 0.005). 133 women had a homogeneous endometrium, i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 127 women, i.e. 84.7%. The sub-endometrial flow was found in 128 women or 85.3%. Conclusion: The Knowledge of the status of the endometrium is essential and has an impact on the outcome of embryo transfers. The thinner (<7) or thicker the endometrium, the higher the failure rate. Optimal endometrial thickness is needed (>7 and <15). Doppler factors also play an important role.

Endometrial Status, Embryonic Implantation, Medically Assisted Procreation

Dembélé, M. , Kouma, A. , Guindo, I. , Sanogo, S. , Berete, Z. , Traoré, O. , N’Diaye, M. , Doumbia, B. , Diarra, O. , Cissé, I. , N’diaye, A. , Doucouré, B. , Yalcouyé, Y. , Keita, A. and Sidibe, S. (2023) Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”. Open Journal of Medical Imaging, 13, 92-100. doi: 10.4236/ojmi.2023.133009.