title: Effect of endometrial thickness on pregnancy outcome after intracytoplasmic sperm injection.
abstract: OBJECTIVE
  To identify cut-off value of endometrial thickness required for implantation of embryo after intracytoplasmic sperm injection.
  
  
  METHODS
  The auasi-experimental study was conducted from July 2011 to June 2012 at an assisted reproductive clinic in Islamabad. Down-regulation of ovaries, controlled ovarian stimulation, oocyte pick-up, in vitro fertilisation, blastocyst transfer and confirmation of pregnancy with beta human chorionic gonadotropin more than 5mIU/ml. Patients were categorised into two groups on the basis of endometrial thickness < 8mm and >8mm.On ovulation induction, before human chorionic gonadotropin injection, endometrial thickness was measured by trans-vaginal scan. Receiver operating curve was used to define groups on the basis of endometrial thickness cut-off value for pregnancy. The groups were compared in terms of the number of retrieved, mature and fertilised oocytes along with oocyte maturity, fertilisation and implantation rates by chi square test.
  
  
  RESULTS
  There were 282 females; 116(41%) in Group A with endometrial thickness < 8mm, and 166(59%) in Group B with endometrial thickness >8mm. In group A, 6(5%) and in Group B, 95(57.2%) patients had a positive pregnancy test. The number of mature, fertilised oocytes and cleaved embryos was significantly high in Group B (p=0.01; p=0.001; p=0.001respectively). Increase in endometrial thickness enhanced chances of oocyte maturity, fertilisation, cleavage and implantation (p< 0.0001 each).
  
  
  CONCLUSIONS
  Endometrial thickness of 8mm was associated with a positive pregnancy outcome after intracytoplasmic sperm injection. Implantation of embryo was facilitated by better oocyte parameters, oocyte maturity, fertilisation and its cleavage in females who exhibited endometrial thickness above the cut-off value.
authors.affiliation: Bahria University Medical and Dental College, Defence Phase I, Karachi, Pakistan.
authors.forename: Rehana
authors.initials: R
authors.lastname: Rehman
authors.affiliation: Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan.
authors.forename: Syeda Sadia
authors.initials: SS
authors.lastname: Fatima
authors.affiliation: Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Mehwish
authors.initials: M
authors.lastname: Hussain
authors.affiliation: Public Health Physician, Freelance Consultant, Karachi, Pakistan.
authors.forename: Rakhshaan
authors.initials: R
authors.lastname: Khan
authors.affiliation: Department of Physiology, University of Karachi, Karachi, Pakistan.
authors.forename: Taseer Ahmed
authors.initials: TA
authors.lastname: Khan
mesh_terms: D000328:Adult; D010064:Embryo Implantation; D004624:Embryo Transfer; D004717:Endometrium / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D009929:Organ Size; D010062:Ovulation Induction; D011247:Pregnancy; D011256:Pregnancy Outcome; D018873:Pregnancy Rate; D020554:Sperm Injections, Intracytoplasmic; D014463:Ultrasonography; D055815:Young Adult
keywords: Intracytoplasmic sperm injection, Ovulation induction, endometrial thickness, Implantation.