New look at endometrial echogenicity: objective computer-assisted measurements predict endometrial receptivity in in vitro fertilization-embryo transfer.
OBJECTIVE
To determine whether endometrial echogenicity, assessed objectively by a computer-assisted system on the day of hCG administration, predicts endometrial receptivity in controlled ovarian hyperstimulation (COH) cycles for IVF-ET.


METHODS
Prospective analysis.


METHODS
Assisted reproduction unit, Clamart, France.


METHODS
Two hundred twenty-one women (aged <38 years with a normal uterus and >/=2 grade A or B embryos transferred) undergoing 228 GnRH agonist and FSH/hCG cycles for IVF-ET.


METHODS
On the day of hCG administration, uterine ultrasound scans were digitized with an image analysis system. Endometrial echogenicity was assessed as the ratio of the extent of the hyperechogenic transformation over the whole endometrial thickness. According to this, cycles were sorted arbitrarily into six groups: <30% (n = 34), 31%-40% (n = 37), 41%-50% (n = 37), 51%-60% (n = 55), 61%-70% (n = 37), and >70% (n = 28).


METHODS
Pregnancy and implantation rates.


RESULTS
The groups were similar in regard to population characteristics, ovarian response to COH, and embryology data. Pregnancy rates (59%, 57%, 35%, 20%, 16%, and 11%, respectively) and implantation rates (35%, 23%, 17%, 6%, 7%, and 3%, respectively) fell progressively and significantly from the low-echogenicity group to the high-echogenicity group.


CONCLUSIONS
The present results confirm and extend previous observations that advanced hyperechogenic transformation of the endometrium is associated with poor IVF-ET outcome.
Department of Obstetrics and Gynecology and Reproductive Endocrinology, Hôpital Antoine Béclère, Clamart, France. renato.fachin@abc.ap-hop-paris.fr
R
R
Fanchin
C
C
Righini
J M
JM
Ayoubi
F
F
Olivennes
D
D
de Ziegler
R
R
Frydman
D000328:Adult; D006063:Chorionic Gonadotropin / Q000627:therapeutic use; D010064:Embryo Implantation; D004624:Embryo Transfer; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000502:physiology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D010053:Ovary / Q000187:drug effects / Q000502:physiology; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D014463:Ultrasonography
D006063:Chorionic Gonadotropin