THE EMBRYO VERSUS ENDOMETRIUM CONTROVERSY REVISITED AS IT RELATES TO PREDICTING PREGNANCY OUTCOME IN IN-VITRO FERTILIZATION-EMBRYO TRANSFERCYCLES

To evaluate embryonic and endometrial factors for their value in predi cting pregnancy outcome in in-vitro fertilization (IVF) and embryo tra nsfer, a retrospective data collection and prospective uterine artery colour Doppler imaging study was performed in a university-based IVF-e mbryo transfer programme setting, A total of 210 patients were include d and grouped as follows: (I) IVF with controlled ovarian stimulation (214 cycles); (II) frozen-thaw cycle of autologous embryos (30 cycles) ; (III) oocyte donation, no cryopreservation (12 cycles); (IV) frozen- thaw cycle with embryos from donated oocytes (10 cycles), Embryo quali ty was significantly better in pregnant than non-pregnant cycles (grou p I, P = 0.0104; groups II-IV, P = 0.0418). The endometrial echo was s ignificantly thicker in pregnant versus non-pregnant patients in group I(P = 0.0059), but not in groups II-IV (P = 0.741). Past uterine surg ery or abnormalities had no effect on pregnancy outcome, There were no significant differences in mean uterine artery resistance index or pe ak systolic velocity in pregnant versus non-pregnant patients in group s II-TV, Thus, embryo quality is the most reliable predictor of pregna ncy outcome, Endometrial measurements were significantly thicker in su bsequently pregnant patients only in group I, where the endometrium re flects the hormonal environment, Doppler parameters were not useful in predicting pregnancy outcome.