Three-dimensional endometrial volume estimation as a predictor of pituitary down-regulation in an IVF-embryo transfer programme.
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.
Yaman
C
C
Women's General Hospital, IVF Unit, University of Linz, Department for Statistics, Austria. yaman@aom.at
Ebner
T
T
Sommergruber
M
M
Hartl
J
J
Pölz
W
W
Tews
G
G
D000328:Adult; D019540:Area Under Curve; D015536:Down-Regulation; D004624:Embryo Transfer; D004717:Endometrium / Q000000981:diagnostic imaging*; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D010902:Pituitary Gland / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D004958:Estradiol