Ultrasound characteristics and histological dating of the endometrium in a natural cycle in infertile women compared with fertile controls.
OBJECTIVE
To compare endometrial dating and ultrasound texture in a natural cycle before IVF and relate these to outcome and to fertile references.


METHODS
Prospective study with a fertile reference group.


METHODS
Four university IVF clinics.


METHODS
Seventy-five IVF patients and 21 fertile women.


METHODS
Ultrasound, biopsy, blood sampling. In vitro fertilization-ET in the following cycle.


METHODS
Endometrial evaluation, P, IVF outcome.


RESULTS
At day LH+7, 42% infertile vs. 67% fertile women demonstrated endometria that were in phase (statistically nonsignificant difference). Nine percent had an accelerated endometrium, and 47% (infertile) vs. 24% (fertile) had a delayed endometrium (statistically nonsignificant difference). Statistically significantly fewer women with tubal factor and no hydrosalpinges had an endometrium in phase (20%) than was the case in fertile women (67%). Dating could not predict outcome. Statistically significantly more women in the hydrosalpinx group had a visible midline at day LH+7 compared with the case in other infertile groups. Forty-three percent conceived after IVF-ET. Plasma P was statistically significantly lower in nonpregnant women compared with in women with ongoing pregnancies and with fertile controls. A periovulatory hyperechogenic endometrium resulted in no ongoing pregnancies.


CONCLUSIONS
In a natural cycle preceding IVF, a low midluteal P level predicts a low implantation rate. A periovulatory hyperechogenic endometrium or hydrosalpinges visible at ultrasound may have some predictive value. Endometrial dating was of no help.
Lindhard
Anette
A
The Fertility Clinic, The Juliane Marie Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. rsnali@ra.dk
Ravn
Vibeke
V
Bentin-Ley
Ursula
U
Horn
Thomas
T
Bangsboell
Susanne
S
Rex
Sven
S
Toft
Bente
B
Soerensen
Steen
S
D000328:Adult; D000375:Aging / Q000473:pathology*; D004717:Endometrium / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D005307:Fertilization in Vitro; D006801:Humans; D007247:Infertility, Female / Q000000981:diagnostic imaging* / Q000473:pathology*; D008597:Menstrual Cycle; D011247:Pregnancy; D016896:Treatment Outcome; D014463:Ultrasonography