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Feasibility of uterine speckle tracking for improved embryo implantation

Infertility problems are involving an increasing number of women, also due to the trend of postponing conception. In-vitro fertilization represents nowadays the most advanced technology to approach infertility problems, but it still shows a low success rate of about 30%. A possible cause may reside in the uterine movement during embryo transfer, possibly hampering successful implantation. Unfortunately, no objective tools are nowadays available for the assessment of uterine movement. With the aim of filling this gap, here we present the first method for quantitative analysis of uterine movement. Being widespread accessible, ultrasound imaging is employed for the analysis. In particular, a speckle-tracking algorithm has been implemented that is based on block matching by normalized cross correlation. Wiener deconvolution is used to regularize the image resolution prior to speckle tracking and correlation filtering is adopted to improve the method reliability. The method feasibility was tested in vitro as well as for its ability to distinguish between active and non-active phase of a natural menstrual cycle in six women. Two pairs of sites were manually defined on the uterine muscle and automatically tracked over time. The extracted movement features permitted successful separation between the two classes (p <; 0.05 by paired, double-tailed Student t-test). Additional validation is however required to prove the clinical value of this method for in-vitro fertilization.