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Three-dimensional ultrasound diagnosis of T-shaped uterus is associated with adverse pregnancy outcomes after embryo transfer.

Publication ,  Journal Article
Neal, SA; Morin, SJ; Werner, MD; Gueye, N-A; Pirtea, P; Scott, RT; Goodman, LR
Published in: Reprod Biomed Online
November 2019

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.

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Published In

Reprod Biomed Online

DOI

EISSN

1472-6491

Publication Date

November 2019

Volume

39

Issue

5

Start / End Page

777 / 783

Location

Netherlands

Related Subject Headings

  • Uterus
  • Urogenital Abnormalities
  • Ultrasonography
  • ROC Curve
  • Prospective Studies
  • Pregnancy, Ectopic
  • Pregnancy Outcome
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Live Birth
 

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Neal, S. A., Morin, S. J., Werner, M. D., Gueye, N.-A., Pirtea, P., Scott, R. T., & Goodman, L. R. (2019). Three-dimensional ultrasound diagnosis of T-shaped uterus is associated with adverse pregnancy outcomes after embryo transfer. Reprod Biomed Online, 39(5), 777–783. https://doi.org/10.1016/j.rbmo.2019.07.030
Neal, Shelby A., Scott J. Morin, Marie D. Werner, Ndeye-Aicha Gueye, Paul Pirtea, Richard T. Scott, and Linnea R. Goodman. “Three-dimensional ultrasound diagnosis of T-shaped uterus is associated with adverse pregnancy outcomes after embryo transfer.Reprod Biomed Online 39, no. 5 (November 2019): 777–83. https://doi.org/10.1016/j.rbmo.2019.07.030.
Neal SA, Morin SJ, Werner MD, Gueye N-A, Pirtea P, Scott RT, et al. Three-dimensional ultrasound diagnosis of T-shaped uterus is associated with adverse pregnancy outcomes after embryo transfer. Reprod Biomed Online. 2019 Nov;39(5):777–83.
Neal, Shelby A., et al. “Three-dimensional ultrasound diagnosis of T-shaped uterus is associated with adverse pregnancy outcomes after embryo transfer.Reprod Biomed Online, vol. 39, no. 5, Nov. 2019, pp. 777–83. Pubmed, doi:10.1016/j.rbmo.2019.07.030.
Neal SA, Morin SJ, Werner MD, Gueye N-A, Pirtea P, Scott RT, Goodman LR. Three-dimensional ultrasound diagnosis of T-shaped uterus is associated with adverse pregnancy outcomes after embryo transfer. Reprod Biomed Online. 2019 Nov;39(5):777–783.
Journal cover image

Published In

Reprod Biomed Online

DOI

EISSN

1472-6491

Publication Date

November 2019

Volume

39

Issue

5

Start / End Page

777 / 783

Location

Netherlands

Related Subject Headings

  • Uterus
  • Urogenital Abnormalities
  • Ultrasonography
  • ROC Curve
  • Prospective Studies
  • Pregnancy, Ectopic
  • Pregnancy Outcome
  • Pregnancy
  • Obstetrics & Reproductive Medicine
  • Live Birth