ENDOMETRIAL THICKNESS IS PREDICTIVE OF HISTOLOGIC ENDOMETRIAL MATURATION IN WOMEN UNDERGOING HORMONE REPLACEMENT FOR OVUM DONATION

Objective: To determine if ultrasonographic endometrial pattern or thi ckness is predictive of histologic endometrial maturation in women und ergoing hormone replacement for ovum donation. Design: Ultrasonographi c endometrial thickness and pattern were determined and compared with histologic assessment of endometrial maturation. Patients: Forty-six w omen underwent 52 preparatory cycles for ovum donation. Transvaginal u ltrasound (US) was performed after 14 days of E(2) replacement and, af ter 12 days of P, an endometrial biopsy was perfor med. In 12 cycles, a continuous dose of 2 mg/d E(2) was administered. In cycles with out- of-phase biopsies (dated earlier than day 24) and in the last 34 cycle s, all women received an escalating; dose of E(2) before initiation of P. Additionally, the 46 women underwent 55 ETs with USs performed on cycle day 15. Results: Six women had abnormal biopsies in their first preparatory cycle on the continuous E(2) protocol, which normalized wi th the escalating protocol. All other women had normal biopsies. Women with abnormal biopsies had significantly thinner endometrium (less th an or equal to 6 mm) but similar endometrial patterns compared with wo men with normal biopsies. In women having US in preparatory and transf er cycles, there were no differences in endometrial thickness or patte rn between examinations. Conclusions: Endometrial thickness greater th an or equal to 7 mm in hormone replacement cycles predicts in phase en dometrial histology and can replace the endometrial biopsy.