Endometrial pattern and thickness associated with pregnancy outcome after assisted reproduction technologies

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Abstract
The endometrial pattern and thickness was analysed prospectively on the day of administration of human chorionic gondotrophin (HCG) in 200 in-vitro fertilization (IVF), gamete intra-Fallopian transfer (GIFT) and tubal embryo transfer (TET) cycles. Increasing maturity of the endometrial pattern was positively correlated with oestradiol levels (r = 0.20; P = 0.005), number of mature eggs (r = 0.13; P < 0.05) and the number of top quality embryos (r = 0.40; P < 0.001). The endometrial thickness was positively correlated with the number of follices ≥ 15 mm (r = 0.15; P < 0.02) and the cycle day on which HCG was administered (r = 0.14; P < 0.03). It was unaffected by the dose of human menopausal gonadotrophin and was negatively correlated with the use of clomiphene citrate (r = 0.40; P < 0.001). Fecundity was increased for IVF when the endometrial thickness was ≥9 mm (P < 0.05) and for GIFT and TET when a Type C triple-line endometrial pattern was present (P < 0.05). Biochemical pregnancies for the combined methods increased from 2.5% of all pregnancies when the endometrial thickness was 9–13 mm, to 27.8% when the thickness was < 9 mm or > 13 mm (P < 0.01). Biochemical pregnancies occurred in 67% of IVF pregnancies when the endometrial thickness was ≥ 13 mm. These findings suggest that fecundity may be increased and biochemical pregnancies may be avoided by administration of HCG when the endometrial thickness is ≥9 mm but still ≤14 mm.

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