Sonographic evaluation of the endometrium in in vitro fertilization IVF cycles: A way to predict pregnancy?

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Abstract
The endometrial thickness and echogenic pattern were prospectively evaluated in 100 patients undergoing IVF‐treatment. On the day before oocyte aspiration (day‐1) the endometrium was significantly thicker in the group of patients achieving an ongoing pregnancy than in the group that failed to conceive. The minimal endometrial thickness on day‐1 compatible with an ongoing pregnancy was 9 mm. Before oocyte aspiration two different endometrial patterns could be distinguished, a multilayered, ‘triple line’, hypoechogenic endometrium (A) and an isoechogenic pattern (B). Other studies have, in addition. described a hyperechogenic endometrium with a poor pregnancy rate but that pattern could in the present study only be demonstrated after follicle aspiration. 32 clinical pregnancies occurred. Among patients with endometrial pattern A, 36% conceived and among patients with pattern B 23% conceived which was not significantly different. It is concluded that the day before aspiration an endometrial thickness of at least 9 mm appears to be required for an ongoing pregnancy. In all cases a triple line (hypo‐or isoechogenic) pattern was evident before aspiration.