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. 2010 Mar 24:8:30.
doi: 10.1186/1477-7827-8-30.

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

Shi-Ling Chen  1 , Fang-Rong Wu, Chen Luo, Xin Chen, Xiao-Yun Shi, Hai-Yan Zheng, Yun-Ping Ni
Affiliations

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

Shi-Ling Chen et al. Reprod Biol Endocrinol. .

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 group 1-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.

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Figures

Figure 1
Figure 1
Longitudinal ultrasound images demonstrate the endometrial pattern. (A) Triple-line pattern: hypoechoic endometrium with well-defined hyperechoic outer walls and a central echogenic line; (B) No-triple line pattern: isoechoic endometrium with poorly defined outer walls and central echogenic line; (C) No-triple line pattern: homogeneous hyperechoic endometrium.
Figure 2
Figure 2
Distribution of endometrial patterns in three endometrial thickness groups. The percentages of endometrial pattern are shown for individual endometrial thickness group.
See this image and copyright information in PMC

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