title: Uterine contractility and elastography as prognostic factors for pregnancy after intrauterine insemination.
abstract: OBJECTIVE
  To determine the impact of the frequency and intensity of uterine contractions (UCs) at the time of IUI on subsequent fertility.
  
  
  METHODS
  Observational pilot study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred volunteer women scheduled for IUI between April 2011 and July 2013, in whom UCs were assessed during the ultrasound before IUI.
  
  
  METHODS
  A two-dimensional sagittal uterus elastography was recorded for 5 minutes. The elasticity index, defined as the mean ratio of elastographic measurements between the subendometrial area (of interest) and the endometrial area (control), was computed. UC frequency, endometrial thickness and volume, and subendometrial vascularisztion were also measured.
  
  
  METHODS
  These parameters, along with characteristics of the IUI cycle, were entered into a logistic regression model for predicting ongoing pregnancy.
  
  
  RESULTS
  The elasticity index was significantly higher (2.4 ± 1.3 vs. 1.5 ± 0.7, i.e., with stiffer myometrium), and the endometrium was significantly less echogenic in future pregnant women. Factors closely reaching significance were age, previous fertility, day 3 hormonal assessments, number of inseminated spermatozoa, endometrial thickness, and UC count. In multivariate analysis, low UC frequency (<2.8/minute; odds ratio [OR] = 0.039), high elasticity index (>1.7; OR = 63.26), high endometrial thickness on the ovulation triggering day (>8 mm; OR = 28.21), and low patient age (<32 years; OR = 0.001) were predictive of pregnancy after IUI.
  
  
  CONCLUSIONS
  A low frequency and high intensity of UCs at the day of IUI appears associated with a higher pregnancy rate. Elastography provides a promising innovative tool for IUI monitoring.
authors.affiliation: EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, Poissy, France.
authors.forename: Nelly
authors.initials: N
authors.lastname: Swierkowski-Blanchard
authors.affiliation: EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Biologie de la Reproduction, Hôpital de Poissy Saint Germain en Laye, Poissy, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Boitrelle
authors.affiliation: EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Biologie de la Reproduction, Hôpital de Poissy Saint Germain en Laye, Poissy, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Alter
authors.affiliation: EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Biologie de la Reproduction, Hôpital de Poissy Saint Germain en Laye, Poissy, France.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Selva
authors.affiliation: Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, Poissy, France.
authors.forename: Thibaud
authors.initials: T
authors.lastname: Quibel
authors.affiliation: EA7404, Gamètes, Implantation, Gestation, Université de Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; Service de Gynécologie Obstétrique, Hôpital de Poissy Saint Germain en Laye, Poissy, France. Electronic address: dr.antoine.torre@gmail.com.
authors.forename: Antoine
authors.initials: A
authors.lastname: Torre
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D004548:Elasticity; D054459:Elasticity Imaging Techniques; D005260:Female; D005298:Fertility; D006785:Hospitals, University; D006801:Humans; D007246:Infertility / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D007315:Insemination, Artificial / Q000009:adverse effects; D050498:Live Birth; D016015:Logistic Models; D016017:Odds Ratio; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011247:Pregnancy; D018873:Pregnancy Rate; D012307:Risk Factors; D016896:Treatment Outcome; D014590:Uterine Contraction; D014599:Uterus / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: Uterine contraction; artificial insemination; elastography; pregnancy rates; ultrasonography