{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T15:15:36Z","timestamp":1786461336643,"version":"build-2736575974"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aims to assess the impact of ultrasound parameters on endometrial receptivity in patients undergoing IVF-ET and to establish a predictive model for ongoing pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The prospective cohort study included 86 patients treated at the Reproductive Center of Xiangtan Central Hospital from May to December 2024. Participants underwent multimodal ultrasound evaluation one day before embryo transfer. The study analyzed endometrial morphology, blood flow parameters, as well as threedimensional power Doppler angiography(3D-PDA), and endometrial contrast-enhanced ultrasound (CEUS) indicators. Multimodal ultrasound parameters were used to establish a predictive model for sustained pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 86 patients, 42 (48.8%) achieved ongoing pregnancy, while 44 (51.2%) did not. Significant differences between the groups were observed in the number of mature oocytes and endometrial blood flow grading (both P\u00a0=\u00a00.005). Lasso regression identified eight predictive variables: primary cause of infertility, baseline luteinizing hormone (LH) levels, number of MII oocytes, uterine cavity volume, endometrial blood flow grading, subendometrial flow index (FI) in 3D-PDA, and endometrial and subendometrial peak intensity (PI) in CEUS. The aforementioned variables as well as embryonic factors were integrated into eight machine learning models, with the Gradient Boosting model exhibiting superior predictive performance (AUC: 0.981). SHapley Additive exPlanations (SHAP) analysis indicated that a higher number of MII oocytes, improved endometrial blood flow, specific infertility etiologies, elevated baseline LH levels, and reduced subendometrial\/endometrial PI, subendometrial FI, and uterine cavity volume were associated with a greater likelihood of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The integration of 3D-PDA and CEUS technologies shifts IVF-ET evaluation from traditional morphological observation to functional assessment, offering a new perspective for predicting sustained pregnancy outcomes. This innovation shows promising clinical potential by optimizing treatment strategies like MII oocyte retrieval, improving endometrial blood flow grading, and adjusting blood flow parameters (PI and FI), significantly enhancing pregnancy success rates and advancing assisted reproductive technologies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1677593","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T05:12:42Z","timestamp":1763442762000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Analysis of ultrasound parameters influencing endometrial receptivity and a pregnancy outcomes predictive model for patients undergoing in vitro fertilization and embryo transfer: a prospective study"],"prefix":"10.3389","volume":"16","author":[{"given":"Chunlian","family":"Wang","sequence":"first","affiliation":[{"name":"Obstetrics and Gynecology Ultrasound Department, Xiangtan Central Hospital, Affiliated Hospital of Hunan University","place":["Xiangtan, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Lin","sequence":"additional","affiliation":[{"name":"Reproductive Center, Xiangtan Central Hospital, Affiliated Hospital of Hunan University","place":["Xiangtan, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingping","family":"Zhao","sequence":"additional","affiliation":[{"name":"Reproductive Center, Third Xiangya Hospital, Affiliated Hospital of Zhongnan University","place":["Changsha, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ni","family":"Liu","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Ultrasound Department, Xiangtan Central Hospital, Affiliated Hospital of Hunan University","place":["Xiangtan, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pengzi","family":"Sun","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Ultrasound Department, Xiangtan Central Hospital, Affiliated Hospital of Hunan University","place":["Xiangtan, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoli","family":"Yang","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Ultrasound Department, Xiangtan Central Hospital, Affiliated Hospital of Hunan University","place":["Xiangtan, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Zhou","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Ultrasound Department, Xiangtan Central Hospital, Affiliated Hospital of Hunan University","place":["Xiangtan, Hunan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dml004","article-title":"Endometrial receptivity markers, the journey to successful embryo implantation","volume":"12","author":"Achache","year":"2006","journal-title":"Hum Reprod Update"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.2095-5227.2021.11.018","article-title":"Research advances in ultrasound evaluation index of endometrial receptivity in prediction of pregnancy outcome with assisted reproductive technology","volume":"42","author":"Song","year":"2021","journal-title":"Acad J Chin PLA Med Sch"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2013.05.007","article-title":"Detection of endometrial and subendometrial vasculature on the day of embryo transfer and prediction of pregnancy during fresh in vitro fertilization cycles","volume":"53","author":"Kim","year":"2014","journal-title":"Taiwanese J Obstetrics Gynecology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"38","DOI":"10.13704\/j.cnki.jyyx.2019.02.014","article-title":"Relationship between ultrasound characteristics of endometrial blood flow parameters and embryo transfer success rate","volume":"37","author":"Li","year":"2019","journal-title":"J Prev Med Chin PLA"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1007\/s13224-016-0871-5","article-title":"Endometrial and subendometrial vascularity by three-dimensional (3D) power Doppler and its correlation with pregnancy outcome in frozen embryo transfer (FET) cycles","volume":"66","author":"Mishra","year":"2016","journal-title":"J Obstetrics Gynecology India"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1080\/09513590.2019.1604660","article-title":"The measurement of endometrial volume and sub-endometrial vascularity to replace the traditional endometrial thickness as predictors of in-vitro fertilization success","volume":"35","author":"Maged","year":"2019","journal-title":"Gynecological Endocrinol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1186\/s12884-023-05534-4","article-title":"Predictive value of 3D ultrasound assessment of endometrial receptivity for PGD\/PGS for transfer pregnancy outcome","volume":"23","author":"Sun","year":"2023","journal-title":"BMC Pregnancy Childbirth"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13244-020-0840-5","article-title":"Application of ultrasound multimodal score in the assessment of endometrial receptivity in patients with artificial abortion","volume":"11","author":"Jiao","year":"2020","journal-title":"Insights into Imaging"},{"key":"B9","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12880-022-00863-w","article-title":"A predictive model for first-trimester pregnancy inception after lVF-ET based on muhimodal ultrasound evaluation of endometrial receptivity","volume":"22","author":"Liao","year":"2022","journal-title":"BMC Med Imaging"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1080\/02648725.2023.2183585","article-title":"Evaluation of endometrial receptivity by ultrasound elastography to predict pregnancy outcome is a non-invasive and worthwhile method","volume":"40","author":"Li","year":"2024","journal-title":"Biotechnol Genet Eng Rev"},{"key":"B11","doi-asserted-by":"publisher","first-page":"104221","DOI":"10.1016\/j.jri.2024.104221","article-title":"Angiogenic factors and the lectin pathway of complement in women with secondary recurrent pregnancy loss","volume":"163","author":"Krog","year":"2024","journal-title":"J Reprod Immunol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.28982\/josam.666963","article-title":"High basal LH levels are associated with improved cycle outcomes of assisted reproduction","volume":"4","author":"Tokg\u00f6z","year":"2020","journal-title":"J Surg Med"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/jum.14319","article-title":"Association between endometrial\/subendometrial vasculature and embryo transfer outcome: A meta-analysis and subgroup analysis","volume":"37","author":"Wang","year":"2018","journal-title":"J Ultrasound Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.19538\/j.fk2020030118","article-title":"Effect of endometrial receptivity evaluation on clinical pregnancy rate in infertile patients on the day of transplantation","volume":"36","author":"Li","year":"2020","journal-title":"Chin J Pract Gynecology Obstetrics"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1004-3845.2017.11.014","article-title":"Influence of endometrial subendometrial blood flow before and after oocyte pick upon pregnancy outcome in single blastocyst transfer cycles","volume":"26","author":"Guo","year":"2017","journal-title":"J Reprod Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2009.03.084","article-title":"Relationship between endometrial and subendometrial blood flow measured by three-dimensional power Doppler ultrasound and pregnancy after intrauterine insemination","volume":"94","author":"Kim","year":"2010","journal-title":"Fertility Sterility"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.4103\/0974-1208.138872","article-title":"Correlation of subendometrial-endometrial blood flow assessment by two-dimensional power Doppler with pregnancy outcome in frozen-thawed embryo transfer cycles","volume":"7","author":"Sardana","year":"2014","journal-title":"J Hum Reprod Sci"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1260960","article-title":"Enhancing endometrial receptivity in FET cycles: exploring the influence of endometrial and subendometrial blood flow along with endometrial volume","volume":"11","author":"Hazari","year":"2024","journal-title":"Front Med"},{"key":"B19","first-page":"6156","article-title":"Development and validation of a pregnancy prediction model based on ultrasonographic features related to endometrial receptivity","volume":"13","author":"Shui","year":"2021","journal-title":"Am J Trans Res"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2015.11.008","article-title":"Comparison of uterine receptivity between fertile and unexplained infertile women by assessment of endometrial and subendometrial perfusion using contrast-enhanced ultrasound: Which index is better\u2014Peak intensity or area under the curve","volume":"42","author":"Chen","year":"2016","journal-title":"Ultrasound Med Biol"},{"key":"B21","article-title":"Evaluation of endometrial receptivity in infertile patients by contrast enhanced ultrasound","volume":"36","author":"Wang","year":"2020","journal-title":"Chin J Med Ultrasound"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deh056","article-title":"Quantifying the changes in endometrial vascularity throughout the normal menstrual cycle with three-dimensional power Doppler angiography","volume":"19","author":"Raine-Fenning","year":"2004","journal-title":"Hum Reprod"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.7863\/jum.2001.20.2.125","article-title":"Assessment of endometrial receptivity by transvaginal color Doppler and three-dimensional power Doppler ultrasonography in patients undergoing in vitro fertilization procedures","volume":"20","author":"Kupesic","year":"2001","journal-title":"J Ultrasound Med"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1055\/a-2351-0747","article-title":"Safety of contrast-enhanced ultrasound using microbubbles in human pregnancy: A scoping review","volume":"46","author":"Dassen","year":"2024","journal-title":"Ultraschall der Medizin-European J Ultrasound"}],"updated-by":[{"DOI":"10.3389\/fendo.2026.1840394","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000}}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1677593\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T10:16:12Z","timestamp":1776680172000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1677593\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":24,"alternative-id":["10.3389\/fendo.2025.1677593"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1677593","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]},"article-number":"1677593"}}