Pelvic sonography.using transvaginal transducer has enabled detection of changes in endometrial thickness and textures as follicular maturation advances.
The study was undertaken to evaluate endometrial thickness and echo patterns in patients who conceived during in vitro fertilization(IVF) compared with those who did not conceive. Uiiulation induction was achieved by modified ultra-short GnRH-agonist protocol.
Ultrasonographic evaluation of the endometrium in 183 IVF cylces was performed from Jun. 1991 to Apr. 1992 in Chung-Ang University Hospital.
Endometrial thickness were measured from the echogenic interface of the endometrium-myo metrium junction on a transverse section at the level of fundus to the opposite interface including the stronger midline echo on 24 hours before HCG injection(Day -1). the day of HCG injection (Day 0). 24 hours after HCG injection(Day +i) and the midluteal phase(Day +6).
Endometrial patterns were assessed on the day of HCG injection(Day 0) and the day of midluteal phase(Day +6), which patterns were classified as Smith criteria.
The mean endometrial thickness and serum E2 levels on Day 0 were not significantly different in conception cycles(n=69) compared with the non-conception cycles(n= 114) (124± 2.7 and 120± 2.3mm, 2634± 463mm, 263± 463 and 2434± 422pg/ml respectively ; NS) and midluteal endometrial thickness was significantly thicker inconception compared with the noncocnception group(15.1± 3.2 and 12.7± 2.8mm, respectively(p<0.005), whereas serum E2 levels were not significantly different(± and ± pg/ml, respectively).
The Endometrial thickness from Day 0 to the day of,midluteal phaseg(D +6) was greater significantly in the pregnant group than in the non-pregnant group(2.7± 2.0 and 0.7± 3.9mm. respectively : p<0.005).
Most of the pregnancies were associated with endometrial grade B(73.9%). No pregnancy was observed when midluteal endometrial thickness was < 11.0mm, the endometrial thickness was <-1.0mm, and endometrial pattern was grade C or D on Day: 0.
It is concluded that both the mean D endometrial thickness from Day 0 to the day of midluteal phase(D +6) and endometrial echo patterns may be useful as predictive parameters for implantation.
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