SONOGRAPHIC ASSESSMENT OF ENDOMETRIAL PATTERN AND THICKNESS IN PATIENTS TREATED WITH HUMAN MENOPAUSAL GONADOTROPINS

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.