ULTRASONOGRAPHIC ENDOMETRIAL CHANGES AFTER INTRAUTERINE INSEMINATION - A COMPARISON OF 2 CATHETERS

Objective: To determine and compare the transvaginal ultrasonographic (US) endometrial changes immediately after IUI using the Edwards Walla ce (H.G. Wallace, Limited, Colchester, Essex, UK) and Tom-Cat (Sherwoo d Medical, St. Louis, MO) catheters. Design: Prospective study. Settin g: IVF unit. Patient(s) and Intervention(s): Eighty-two infertile pati ents underwent 112 cycles of ovulation induction with IUI. Either the Edwards Wallace catheter (group 1, n = 32) or the Tom-Cat catheter (gr oup 2, n = 80) was used for sperm insemination. The presence of an end ometrial three-layer pattern before IUI was a prerequisite for inclusi on in the study. After each IUI, the endometrium was reassessed by tra nsvaginal US. Main Outcome Measure(s): Ultrasonographic endometrial ch anges, clinical pregnancy rates (PRs), complications, and patients' co mplaints were compared between the two groups. Result(s): Total destru ction of the endometrial three-layer pattern was observed in 12.5% of the cycles in group 1, compared with 50% of the cycles in group 2. Cli nical pregnancies occurred in 14 (12.5%) of the 112 IUI cycles. A high er PR was achieved when the endometrial three-layer pattern was preser ved after IUI. The patients in group 2 had more complaints of bleeding and pain during the procedure. Conclusion(s): Ultrasonographic change s after IUI suggest that the Edwards Wallace catheter is significantly less traumatic to the endometrium than the Tom-Cat catheter. Although both catheters yielded the same overall PR, there was a trend indicat ing that sparing the endometrial three-layer pattern from damage incre ases the chance of conception. (C) 1997 by American Society for Reprod uctive Medicine.