Accurate prediction of endometrial receptivity remains a key challenge in assisted reproductive technology (ART), with implantation failure often attributed to suboptimal endometrial conditions. This prospective observational study was conducted at the Department of Reproductive Medicine p p = 0.0417), and lower peristalsis (2 vs 3 waves/min; p = 0.0231) than those who did not conceive. Male factor infertility was more frequent in the pregnant than in the non-pregnant cohort (32.03% vs 10.45%; p p < 0.05). Three scoring systems were developed: the Total Screening Score (all predictors), the Targeted Endometrial Receptivity Score (volume, vascularity, peristalsis), and the Endometrial Volume Score. The Total Screening Score (≥14) offered the highest specificity (0.712) but poor sensitivity (0.097) and overall accuracy (0.464). The Targeted Score (≥7) achieved balanced performance, with sensitivity 0.631, specificity 0.621, accuracy 0.625, and the highest positive likelihood ratio (1.665). The Endometrial Volume Score (≥2) demonstrated the best sensitivity (0.796) and negative predictive value (0.727), serving as a strong screening tool, though limited by low specificity (0.366). This study introduces the first multiparametric ultrasound-based scoring framework for FET outcomes developed in the Indian context. The Targeted Endometrial Receptivity Score provides a balanced, reproducible tool for FET planning and patient counselling, while endometrial volume alone can serve as a rapid screening parameter. These systems offer a cost-effective, non-invasive approach to optimise FET outcomes, though validation in larger, multicentre cohorts is warranted.
Agarwal et al. (Sat,) studied this question.