Infertility. Three-dimensional endometrial volume estimation as a predictor of pituitary down-regulation in an IVF–embryo transfer programme

Author： Yaman C.

Publisher： Oxford University Press

ISSN： 1460-2350

Source： Human Reproduction, Vol.15, Iss.8, 2000-08, pp. : 1698-1702

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Abstract

To examine the role of three-dimensional (3D) volume estimation in predicting pituitary down-regulation in an IVF–embryo transfer programme, 46 women were treated with buserelin acetate for down-regulation prior to and concomitantly with ovarian stimulation. Receiver operating characteristic (ROC) curve analysis was used for statistics. The area under the curve (AUC) provides a measure to show how good (AUC close to 1) or how poor (AUC close to 0.5) a test is. If down-regulation was defined as oestradiol <40,><60 or=""><80 pg/ml,="" the="" auc="" of="" 3d-ultrasound="" was="" 0.57,="" 0.83="" and="" 0.97="" respectively.="" the="" highest="" sensitivity="" (100%)="" and="" specificity="" (93.2%)="" of="" 3d-ultrasound="" was="" achieved="" if="" down-regulation="" was="" defined="" as="" oestradiol=""><80 pg/ml="">n = 44), with an endometrial volume of 1.9 ml. If down-regulation was defined as oestradiol <60 pg/ml="">n = 42) the best combination of highest sensitivity (95.2%) and specificity (75.0%) was obtained with an endometrial volume of 1.9 ml. The comparison of 3D volume calculation with endometrial thickness measurement revealed no significant difference in predicting down-regulation. 3D volume estimation provides a new tool for diagnosing relative hypo-oestrogenism or down-regulation, but it was not superior to two-dimensional ultrasound.