Preoperative ultrasonic assessment of women undergoing gamete intrafallopian transfer: a prospective study of 350 cases.
A total of 350 women due to undergo gamete intrafallopian transfer were scanned vaginally on the operation day and the findings were compared with those recorded 2 days previously when human chorionic gonadotropin was administered. The aim was to assess the clinical value of ultrasound assessment on the operation day, especially from a prognostic point of view. Seven women (2%) were found to have already ovulated and evidence of imminent ovulation was detected in another 27 cases (7.7%). There were more frequent and more marked increases in the number of follicles with a diameter of > 14 mm, in the diameter of the leading follicle and in the endometrial thickness in the women who subsequently conceived. The endometrial reflectivity was brighter than the myometrium (grade A) in 77.3% of the women who conceived, compared with only 37.5% of those who did not conceive. These differences were statistically significant. It was concluded that follicular and endometrial changes recorded on the day of gamete intrafallopian transfer may have a prognostic value, as the pregnancy rate was higher in women who had the favorable ultrasonographic features outlined in the study.
Guirgis
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London Fertility Centre, Cozens House, 112A Harley Street, London, UK.
Alshawaf
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Craft
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