Skip to main content
Top
Published in: Reproductive Biology and Endocrinology 1/2010

Open Access 01-12-2010 | Research

Combined analysis of endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer: a retrospective cohort study

Published in: Reproductive Biology and Endocrinology | Issue 1/2010

Login to get access

Abstract

Objective

To evaluate the combined effect of endometrial thickness and pattern on clinical outcome in patients undergoing in vitro fertilization/intracytoplasmic sperm injection and embryo transfer (IVF/ICSI-ET).

Methods

Cycles of IVF/ICSI-ET conducted between January 2003 and December 2008 at a university-based reproductive center were reviewed retrospectively. Endometrial ultrasonographic characteristics were recorded on the day of hCG administration. In the combined analysis, endometrial thickness groups (group 1: equal or <7 mm; group 2: 7-14 mm; group 3: >14 mm) were subdivided into two endometrial patterns (pattern A: triple-line; pattern B: no-triple line). Clinical pregnancy rate (CPR) and early miscarriage rate in different groups were analyzed.

Results

A total of 2896 cycles were reviewed. Clinical pregnancy rate (CPR) was 24.4% in group1-A. There were no second trimester pregnancies in group 1-B. Miscarriage rate in group 2-A was significantly lower compared to group 2-B (P < 0.01), although CPR did not show any significant differences between the groups. A no-triple line endometrial pattern with moderate endometrial thickness (7-14 mm) had a detrimental effect on pregnancy outcome, but not the occurrence of pregnancy. In group 3, there was no difference in CPR and miscarriage rates between the two patterns; adequate endometrial thickness (>14 mm) seemed to mitigate the detrimental impact (high miscarriage rate) of pattern B.

Conclusion

Combined analysis of endometrial thickness and pattern on the day of hCG administration was a better predictor of the outcome of IVF/ICSI-ET and may be more helpful for patient counseling than the separate analyses.
Appendix
Available only for authorised users
Literature
1.
go back to reference Killick SR: Ultrasound and the receptivity of the endometrium. Reprod BioMed Online. 2007, 15: 63-67.CrossRefPubMed Killick SR: Ultrasound and the receptivity of the endometrium. Reprod BioMed Online. 2007, 15: 63-67.CrossRefPubMed
2.
go back to reference Friedler S, Schenker JG, Herman A, Lewin A: The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Hum Reprod Update. 1996, 2: 323-334. 10.1093/humupd/2.4.323.CrossRefPubMed Friedler S, Schenker JG, Herman A, Lewin A: The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Hum Reprod Update. 1996, 2: 323-334. 10.1093/humupd/2.4.323.CrossRefPubMed
3.
go back to reference Oliveira JBA, Baruffi RLR, Mauri AL, Petersen CG, Borges MC, Franco JG: Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme after ovarian stimulation and gonadotrophin-releasing hormone and gonadotrophins. Hum Reprod. 1997, 12: 2515-2518. 10.1093/humrep/12.11.2515.CrossRefPubMed Oliveira JBA, Baruffi RLR, Mauri AL, Petersen CG, Borges MC, Franco JG: Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme after ovarian stimulation and gonadotrophin-releasing hormone and gonadotrophins. Hum Reprod. 1997, 12: 2515-2518. 10.1093/humrep/12.11.2515.CrossRefPubMed
4.
go back to reference Noyes N, Liu HC, Sultan K, Schattman G, Rosenwaks Z: Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod. 1995, 10: 919-922.PubMed Noyes N, Liu HC, Sultan K, Schattman G, Rosenwaks Z: Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod. 1995, 10: 919-922.PubMed
5.
go back to reference Richter KS, Bugge KR, Bromer JG, Levy MJ: Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril. 2007, 87: 53-59. 10.1016/j.fertnstert.2006.05.064.CrossRefPubMed Richter KS, Bugge KR, Bromer JG, Levy MJ: Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril. 2007, 87: 53-59. 10.1016/j.fertnstert.2006.05.064.CrossRefPubMed
6.
go back to reference Al-Ghamdi A, Coskun S, Al-Hassan S, AL-Rejjal R, Awartani K: The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reprod Biol Endocrinol. 2008, 6: 37-10.1186/1477-7827-6-37.PubMedCentralCrossRefPubMed Al-Ghamdi A, Coskun S, Al-Hassan S, AL-Rejjal R, Awartani K: The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reprod Biol Endocrinol. 2008, 6: 37-10.1186/1477-7827-6-37.PubMedCentralCrossRefPubMed
7.
go back to reference Yuval Y, Lipitz S, Dor J, Achiron R: The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization. Hum Reprod. 1999, 14: 1067-1071. 10.1093/humrep/14.4.1067.CrossRefPubMed Yuval Y, Lipitz S, Dor J, Achiron R: The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization. Hum Reprod. 1999, 14: 1067-1071. 10.1093/humrep/14.4.1067.CrossRefPubMed
8.
go back to reference Rashidi BH, Sadeghi M, Jafarabadi M, Nejad EST: Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern. Eur J Obstet Gynecol Reprod Biol. 2004, 120: 179-184. 10.1016/j.ejogrb.2004.08.016.CrossRef Rashidi BH, Sadeghi M, Jafarabadi M, Nejad EST: Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern. Eur J Obstet Gynecol Reprod Biol. 2004, 120: 179-184. 10.1016/j.ejogrb.2004.08.016.CrossRef
9.
go back to reference Weissman A, Gotlieb L, Casper RF: The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril. 1999, 71: 147-149. 10.1016/S0015-0282(98)00413-0.CrossRefPubMed Weissman A, Gotlieb L, Casper RF: The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril. 1999, 71: 147-149. 10.1016/S0015-0282(98)00413-0.CrossRefPubMed
10.
go back to reference Dietterich C, Check JH, Choe JK, Nazari A, Lurie D: Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer. Fertil Steril. 2002, 77: 781-786. 10.1016/S0015-0282(01)03276-9.CrossRefPubMed Dietterich C, Check JH, Choe JK, Nazari A, Lurie D: Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer. Fertil Steril. 2002, 77: 781-786. 10.1016/S0015-0282(01)03276-9.CrossRefPubMed
11.
go back to reference Gonen Y, Calderon I, Dirnfeld M, Abramovici H: The impact of sonographic assessment of the endometrium and meticulous hormonal monitoring during natural cycles in patients with failed donor artificial insemination. Ultrasound Obstet Gynecol. 1991, 1: 122-126. 10.1046/j.1469-0705.1991.01020122.x.CrossRefPubMed Gonen Y, Calderon I, Dirnfeld M, Abramovici H: The impact of sonographic assessment of the endometrium and meticulous hormonal monitoring during natural cycles in patients with failed donor artificial insemination. Ultrasound Obstet Gynecol. 1991, 1: 122-126. 10.1046/j.1469-0705.1991.01020122.x.CrossRefPubMed
12.
go back to reference Check JH, Lurie D, Dietterich C, Callan C, Baker A: Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization. Hum Reprod. 1993, 8: 1293-1296.PubMed Check JH, Lurie D, Dietterich C, Callan C, Baker A: Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization. Hum Reprod. 1993, 8: 1293-1296.PubMed
13.
go back to reference Järvelä IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G: Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol. 2005, 26: 765-769. 10.1002/uog.2628.CrossRefPubMed Järvelä IY, Sladkevicius P, Kelly S, Ojha K, Campbell S, Nargund G: Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol. 2005, 26: 765-769. 10.1002/uog.2628.CrossRefPubMed
14.
go back to reference Kovacs P, Matyas S, Boda K, Kaali SG: The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod. 2003, 18: 2337-2341. 10.1093/humrep/deg461.CrossRefPubMed Kovacs P, Matyas S, Boda K, Kaali SG: The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod. 2003, 18: 2337-2341. 10.1093/humrep/deg461.CrossRefPubMed
15.
go back to reference Zhang XQ, Chen CH, Confino E, Barnes R, Milad M, Kazer RR: Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2005, 83: 336-340. 10.1016/j.fertnstert.2004.09.020.CrossRefPubMed Zhang XQ, Chen CH, Confino E, Barnes R, Milad M, Kazer RR: Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2005, 83: 336-340. 10.1016/j.fertnstert.2004.09.020.CrossRefPubMed
16.
go back to reference Chuang CC, Chen CD, Chao KH, Chen SU, Ho HN, Yang YS: Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization. Fertil Steril. 2003, 79: 63-68. 10.1016/S0015-0282(02)04562-4.CrossRefPubMed Chuang CC, Chen CD, Chao KH, Chen SU, Ho HN, Yang YS: Age is a better predictor of pregnancy potential than basal follicle-stimulating hormone levels in women undergoing in vitro fertilization. Fertil Steril. 2003, 79: 63-68. 10.1016/S0015-0282(02)04562-4.CrossRefPubMed
17.
go back to reference Yoeli R, Ashkenazi J, Orvieto R, Shelef M, Kaplan B, Bar-Hava I: Significance of increased endometrial thickness in assisted reproduction technology treatments. J Assist Reprod Genet. 2004, 21: 285-289. 10.1023/B:JARG.0000043701.22835.56.PubMedCentralCrossRefPubMed Yoeli R, Ashkenazi J, Orvieto R, Shelef M, Kaplan B, Bar-Hava I: Significance of increased endometrial thickness in assisted reproduction technology treatments. J Assist Reprod Genet. 2004, 21: 285-289. 10.1023/B:JARG.0000043701.22835.56.PubMedCentralCrossRefPubMed
18.
go back to reference Gonen Y, Capsper RF: Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF). J In Vitro Fert Embryo Transfer. 1990, 7: 146-152. 10.1007/BF01135678.CrossRef Gonen Y, Capsper RF: Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF). J In Vitro Fert Embryo Transfer. 1990, 7: 146-152. 10.1007/BF01135678.CrossRef
19.
go back to reference Gonen Y, Casper RF, Jacobson W, Blankier J: Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril. 1989, 52: 446-450.PubMed Gonen Y, Casper RF, Jacobson W, Blankier J: Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization. Fertil Steril. 1989, 52: 446-450.PubMed
20.
go back to reference Shapiro H, Cowell C, Casper RF: The use of vaginal ultrasound for monitoring endometrial preparation in a donor oocyte program. Fertil Steril. 1993, 59: 1055-1058.PubMed Shapiro H, Cowell C, Casper RF: The use of vaginal ultrasound for monitoring endometrial preparation in a donor oocyte program. Fertil Steril. 1993, 59: 1055-1058.PubMed
21.
go back to reference Coulam CB, Bustillo M, Soenksen DM, Britten S: Ultrasonographic predictors of implantation after assisted reproduction. Fertil Steril. 1994, 62: 1004-1010.PubMed Coulam CB, Bustillo M, Soenksen DM, Britten S: Ultrasonographic predictors of implantation after assisted reproduction. Fertil Steril. 1994, 62: 1004-1010.PubMed
22.
go back to reference Sundström P: Establishment of a successful pregnancy following in-vitro fertilization with an endometrial thickness of on more than 4 mm. Hum Reprod. 1998, 13: 1550-1552. 10.1093/humrep/13.6.1550.CrossRefPubMed Sundström P: Establishment of a successful pregnancy following in-vitro fertilization with an endometrial thickness of on more than 4 mm. Hum Reprod. 1998, 13: 1550-1552. 10.1093/humrep/13.6.1550.CrossRefPubMed
23.
go back to reference Noyes N, Hampton BS, Berkeley A, Licciardi F, Grifo J, Krey L: Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis. Fertil Steril. 2001, 76: 92-97. 10.1016/S0015-0282(01)01823-4.CrossRefPubMed Noyes N, Hampton BS, Berkeley A, Licciardi F, Grifo J, Krey L: Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis. Fertil Steril. 2001, 76: 92-97. 10.1016/S0015-0282(01)01823-4.CrossRefPubMed
24.
go back to reference Mercé LT, Barco MJ, Bau S, Troyano J: Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome?. Fertil Steril. 2008, 89: 111-117. 10.1016/j.fertnstert.2007.02.029.CrossRefPubMed Mercé LT, Barco MJ, Bau S, Troyano J: Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome?. Fertil Steril. 2008, 89: 111-117. 10.1016/j.fertnstert.2007.02.029.CrossRefPubMed
Metadata
Title
Combined analysis of endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer: a retrospective cohort study
Publication date
01-12-2010
Published in
Reproductive Biology and Endocrinology / Issue 1/2010
Electronic ISSN: 1477-7827
DOI
https://doi.org/10.1186/1477-7827-8-30

Other articles of this Issue 1/2010

Reproductive Biology and Endocrinology 1/2010 Go to the issue