title: Prediction of pituitary down-regulation by evaluation of endometrial thickness in an IVF programme.
abstract: The aim of this retrospective study was to determine whether pituitary down-regulation after gonadotrophin-releasing hormone analogue (GnRHa) administration can be accurately predicted by transvaginal ultrasonographic measurement of endometrial thickness in the presence of menstruation. All cycles of an IVF/intracytoplasmic sperm injection programme in which a long protocol of GnRHa was used for ovarian stimulation were analysed. Overall, 209 patients underwent 223 treatment cycles. Using a serum oestradiol concentration of 50 pg/ml as a cut-off point, the sensitivity, specificity, predictive value and false positive and false negative values were calculated for prediction of pituitary down-regulation from endometrial thickness measurements. Pituitary down-regulation was achieved in 223 treatment cycles in 180 patients (80%). The best combination of the highest specificity (71.7%) and sensitivity (62.5%) is achieved with a linear appearance of the endometrium. Therefore, ultrasonographic measurement of endometrial thickness should be used in combination with serum oestradiol concentration in estimating pituitary down-regulation after GnRHa. In conclusion, the linear appearance of endometrium can be as reliable as serum oestradiol concentration in prediction of pituitary down-regulation after GnRHa.
authors.affiliation: Centre for Reproductive Medicine, Zekai Tahir Burak Women's Health Research and Education Hospital, Ankara, Turkey. muadogan@ttnet.net.tr
authors.forename: Muammer M
authors.initials: MM
authors.lastname: Dogan
authors.forename: Dilek
authors.initials: D
authors.lastname: Uygur
authors.forename: Reyhan Neslihanoglu
authors.initials: RN
authors.lastname: Alkan
authors.forename: Sertaç
authors.initials: S
authors.lastname: Batioglu
authors.forename: Leyla
authors.initials: L
authors.lastname: Mollamahmutoglu
mesh_terms: D015536:Down-Regulation; D004717:Endometrium / Q000000981:diagnostic imaging / Q000502:physiology*; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005300:Fertility Agents, Female / Q000494:pharmacology; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives* / Q000494:pharmacology; D006801:Humans; D008598:Menstruation / Q000378:metabolism; D010902:Pituitary Gland / Q000187:drug effects* / Q000378:metabolism; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D005300:Fertility Agents, Female; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol