Mk. Bohrer et al., SONOGRAPHIC ASSESSMENT OF ENDOMETRIAL PATTERN AND THICKNESS IN PATIENTS TREATED WITH HUMAN MENOPAUSAL GONADOTROPINS, Fertility and sterility, 66(2), 1996, pp. 244-247
Objective: To analyze sonographically the endometrium in patients unde
rgoing controlled ovarian stimulation with menotropins in order to det
ermine the significance of endometrial pattern and thickness on pregna
ncy rate. Design: This is a prospective, nonrandomized study comparing
pregnancy rates in patients with hyperechoic homogeneous patterns wit
h those in patients with isoechoic or hypoechoic trilaminar patterns.
Setting: Tertiary infertility center. Patients: All patients receiving
menotropin therapy at a tertiary infertility center. Interventions: A
ll patients received individualized dosing of hMG starting on cycle da
y 3. Transvaginal sonography was performed 15 hours before hCG adminis
tration and the endometrium was assessed. Main Outcome Measure: Occurr
ence of pregnancy as determined by serially rising beta-hCG titers and
sonographic confirmation. Results: During the study period, 175 patie
nts were evaluated. Thirty-four (19%) patients had a homogeneous endom
etrium, whereas 141 (81%) patients had a trilaminar pattern. There was
1 pregnancy(2.9%) among women with a homogeneous endometrial pattern
and 33 pregnancies (23%) among those with a trilaminar pattern. No sig
nificant differences were found in mean E(2) level, follicle numbers,
parity, and diagnosis between the two groups. Conclusion: In patients
receiving menotropins, a homogeneous pattern is a bad prognostic sign,
regardless of endometrial thickness.