Characterization of the uterine junctional zone prior to IVF/ICSI: an observational study.

Purpose: The uterine junctional zone as documented by magnetic resonance imaging (MRI) has shown to be of significance with respect to the early process of human reproduction. In this study, MRI findings were related to the outcome of an IVF/ICSI program.

Materials And Methods: In 113 infertile women, the diameter of the anterior and posterior junctional zone (JZ) myometrium was documented by MRI prior to the use of ART. Each group of women was also subdivided according to the presence (MI/GV>0%) or absence (MI/GV=0%) of metaphase I(MI) and germinal vesicle (GV) oocytes. The MRI measurements were related to these and further parameters like expansion of the cumulus oophorus, pronuclei stages, embryo morphology and pregnancy rates.

Results: In all women with MI/GV=0%, the JZ myometrium was significantly enlarged (p<0.004) and the clinical pregnancy rate was significantly lower (p<0.025) when compared to the women with MI/GV>0%. The baby take home rates tended to the same results, but were not significantly different. No direct influence of the JZ on all other parameters could be observed.

Conclusions: The JZ, as documented by MRI, might interfere with follicular function.