Endometrial preparedness is one of several factors which may influence the success of in vitro fertilization and embryo transfer(IVF-ET). Vaginal sonography has been recently provided noninvasive visualization of endometrial characteristics,
expressed
in terms of patterns of echogenicity and thickness. There have been a number of reports on sonographic endometrial patterns which, when assessed following controlled ovarian hyperstimulation(COH) in preparation for IVF-ET, were predictive of
outcome. We
needed the hormone replacement therapy(HRT) for good outcome before COH in patients of previous endometrial poor development.
A total of 360 infertile women who underwent 412 cycles of ovarian hyperstimulation for IVF-ET from July 1992 to April 1994, had sonographic assessment of the endometrium. The 120 infertile women(142 cycles) had developed poor endometrial
lining(<10.0
mm on hCG day) following natural cycle(58 patients, 64 cycles) and COH(62 patients, 78 cycles) had also sonographic assessment.
The pregnancy rates were statistically different in the endometrial thickness in the groups of below 10.0 mm versus the groups of above 10.0 mm on the day of hCG administration. The pregnancy rate was higher in the Grade B(I, II) of both groups
of
endometrial thickness(<10.0 mm and>10.0mm), whereas no pregnancy occurred in Grade C of the both groups.
The endometrial thickness of nonconception group and conception group was also not statistically different(r=0.258, p<0.371) when the endomentrial thickness was <10.0 mm. A good correlation was found between the endometrial thickness of
nonconception
group and conception group(r=0.996, p=0.002), whereas the endometrial thickness and pregnancy rate were not statistically different(r=-0.2883, p=0.358) when the endometrial thickness was > 10.0 mm.
Total coversion rate endometrial thickness following COH that enometrial thickness of <10.0mm developed>10.0 mm was 18/64 cycles(28.1%). Total conversion rate following HRT that endometrial thickness of < 10.0 mm developed >10.0 mm was 39/78
cycles(48.7%).
It is suggested that if a poor endometrial response persists in subsequent cycles of ovarian stimulation, the remaining step is hormone replacement therapy.
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