Background Endometrial blood flow is an important index to evaluate endometrial receptivity. Currently, there is a lack of an effective and quantitative ultrasonic evaluation index for endometrial blood flow.

Objective To investigate the characteristics of endometrial receptivity of infertile women of childbearing age with assisted reproductive technology under MV-Flow ultrasound imaging technology and its ability to predict the pregnancy outcome of assisted reproductive technology.

Methods Female infertility patients of childbearing age who underwent transvaginal and pelvic gynecologic ultrasound examination in the First Medical Center of Chinese PLA General Hospital from May to December 2022 were selected as the study objects, and healthy women of childbearing age who underwent the same examination during the same period were selected as the control group. MV-Flow ultrasound imaging technology was used to analyze and compare the differences in endometrium-related parameters between the two groups. The pregnancy outcome after assisted reproductive technology was followed up in the infertile group, and the value of MV-Flow ultrasound imaging in predicting successful pregnancy was evaluated.

Results There were 59 cases in the assisted reproductive technology infertility group with age of (35.41 ± 4.89) years, and 62 cases were in the healthy control group with age of (33.10 ± 5.09) years, and the difference between the two groups was statistically significant (P=0.012). In matched group, the endometrial thickness M(IQR): 0.9(0.7 - 1.0) cm vs 0.8 (0.6 - 0.9) cm, volume M(IQR): 3.71(2.66 - 5.10) mL vs 2.90 (2.03 - 3.99) mL, three-dimensional energy FI \bar x ± s:(27.88 ± 10.33) dB vs (23.84 ± 10.42) dB and VI_MV M(IQR): 12.20 (5.15 - 19.36)% vs 7.13 (3.08 - 14.12)% were significantly higher than those in infertility group (all P<0.05). The pregnancy outcomes of the infertility group were followed up, and there were 29 cases in the pregnant group (age, 33.43 ± 3.95 years) and 30 cases in the non-pregnant group (age, 37.66 ± 5.01 years), and the difference in age between the two groups was statistically significant (P=0.009). In pregnant group, endometrial three-dimensional energy FI \bar x ± s (28.88 ± 7.92) dB vs (18.54 ± 10.27) dB, VI_MV M(IQR): 13.42 (5.45 - 16.99)% vs 5.16 (2.17 - 7.73)% and AMH M(IQR): 2.49(1.24 - 6.05) ng/mL vs 1.61 (0.80 - 2.49) ng/mL was higher than that in non-pregnant group and the difference was statistically significant (P<0.05). The area under the curve of endometrial VI_MV for predicting successful pregnancy was about 0.794, and the area under the curve of VI_MV combined with age, FI, AMH and their combinations to predict pregnancy outcome was between 0.815 and 0.871, among which the area under the curve of endometrial VI_MV combined with age, FI and F1 was the largest (AUC=0.871).

Conclusion MV-Flow ultrasound imaging technology can provide a reliable imaging reference for the prediction of successful pregnancy with assisted reproductive technology.