Uterine biophysical profile

Last revised by David Luong on 27 Jun 2021

Uterine biophysical profile is a sonographic examination of the uterus that assess seven sonographic characteristics used to predict successful conception. 

Uterine scoring system for reproduction (USS)

The uterine scoring system for reproduction comprises the following parameters, taken in mid-cycle:

1. endometrial thickness

  • < 7 mm: 0
  • 7-9 mm: 2
  • 10-14 mm: 3
  • > 14 mm: 1

2. endometrial layering

  • no layering: 0
  • hazy trilaminar: 1
  • distinct trilaminar: 2

3. myometrial contractions (need close look for wave-like endometrial motion). advised to save cine image for two minutes at low frame rate, and check back in slow frames)

  • < 3 contractions in 2 minutes: 0
  • > 3 contractions in 2 minutes: 1

4. myometrial echogenicity

  • coarse/heterogeneous: 1
  • homogeneous: 2

5. uterine artery Doppler

  • PI > 3: 0
  • PI 2.5-2.99: 1
  • PI 2.2-2.49: 2
  • PI < 2.19: 3

6. endometrial blood flow in zone 3 (i.e. hypoechoic inner layer of endometrium)

  • absent: 0
  • sparse: 2
  • abundant: 5

7. myometrial blood flow internal to arcuate vessels (see on grey-scale)

  • absent: 0
  • present: 2

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