title: Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization.
abstract: We have previously presented data to show that in patients who had in-vitro fertilization (IVF)-embryo transfer using ovarian stimulation involving the luteal phase leuprolide acetate--human menopausal gonadotrophin (HMG) regimen, poor pregnancy results ensued if either the endometrial thickness was < 10 mm or a homogeneous hyperechogenic sonographic pattern was present immediately prior to taking a human chorionic gonadotrophin (HCG) injection. There were only 15 cases with this hyperechogenic type endometrium (and no pregnancies). The purpose of the present study was to evaluate the influence of a hyperechogenic endometrium when the endometrial thickness was > or = 10 mm, in a more extensive series, in women having IVF-embryo transfer using the same ovarian stimulation regimen. A total of 273 consecutive cycles, where endometrial thickness was > or = 10 mm, were evaluated (not including the 85 cycles previously reported). Of 22 patients with the hyperechogenic pattern, one achieved a chemical pregnancy (beta-HCG > 500 mIU/ml) and none achieved clinical pregnancies (ultrasound confirmation). In contrast, 67 of 251 (26.7%) patients conceived with other echo patterns (chi 2 analysis = 5.9, df = 1, P = 0.01). These data thus confirm, in a larger series, the negative influence of this type of echo pattern on subsequent pregnancy rates following the luteal phase leuprolide acetate--HMG ovarian stimulation regimen.
authors.affiliation: University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden.
authors.forename: J H
authors.initials: JH
authors.lastname: Check
authors.forename: D
authors.initials: D
authors.lastname: Lurie
authors.forename: C
authors.initials: C
authors.lastname: Dietterich
authors.forename: C
authors.initials: C
authors.lastname: Callan
authors.forename: A
authors.initials: A
authors.lastname: Baker
mesh_terms: D004624:Embryo Transfer; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology; D004958:Estradiol / Q000097:blood; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D016729:Leuprolide / Q000627:therapeutic use; D008596:Menotropins / Q000627:therapeutic use; D011247:Pregnancy; D011374:Progesterone / Q000097:blood; D011379:Prognosis; D014463:Ultrasonography
chemical_list: D011374:Progesterone; D004958:Estradiol; D008596:Menotropins; D016729:Leuprolide