Uterine biophysical profile after intrauterine instillation of autologous blood cell derivative (ABCD) for thin endometrium in frozen embryo transfer cycles

Abstract Purpose This study was conducted to investigate the changes in the uterine biophysical profile (UBP) before and after intrauterine administration of Autologous Blood Cell Derivatives (ABCD). Methods This prospective observational study investigates endometrial receptivity in frozen embryo transfer (FET) cycles. It focuses on patients with thin endometrium (TEM), a basal serum FSH below 10 IU/L, and good-quality frozen embryos. The study utilizes the UBP to evaluate endometrial receptivity both before and after the ABCD procedure. Results The study involved 33 women with TEM undergoing FET cycles. ABCD was administered during the first, second, and third or later FET cycles in 21.21%, 45.45%, and 33.33% of patients, respectively. Following ABCD administration, significant improvements were observed in UBP scores (from 9.06 to 14.85), EMT (from 6.6 mm to 8.67 mm), blood flow to zone III (from 0.85 mm to 3.36 mm), and uterine artery pulsatility index (PI) (from 0.7 to 0.97). Odds ratio analysis showed an association between pregnancy and endometrial layering (OR = 2.12), though it was not statistically significant. Multivariate analysis revealed that the UBP score predicted pregnancy with 68% accuracy, while the ROC analysis yielded an accuracy of 54%. A UBP threshold score of 20 offered 100% specificity, making it a potentially reliable predictor of successful implantation. Conclusions This study demonstrates that ABCD growth factors significantly enhance endometrial development in women with TEM, resulting in improved UBP scores, reduced EMT, lower uterine artery PI, and increased uterine blood flow. A UBP score cutoff of 20 demonstrated 95% sensitivity, highlighting its potential as a reliable prognostic tool in infertility treatment.