ADVERSE EFFECT OF A HOMOGENEOUS HYPERECHOGENIC ENDOMETRIAL SONOGRAPHIC PATTERN, DESPITE ADEQUATE ENDOMETRIAL THICKNESS ON PREGNANCY RATES FOLLOWING IN-VITRO FERTILIZATION

We have previously presented data to show that in patients who had in- vitro fertilization (IVF)-embryo transfer using ovarian stimulation in volving the luteal phase leuprolide acetate-human menopausal gonadotro phin (HMG) regimen, poor pregnancy results ensued if either the endome trial thickness was <10 mm or a homogeneous hyperechogenic sonograpic pattern was present immediately prior to taking a human chorionic gona dotrophin (HCG) injection. There were only 15 cases with this hyperech ogenic type endometrium (and no pregnancies). The purpose of the prese nt study was to evaluate the influence of a hyperechogenic endometrium when the endometrial thickess was greater-than-or-equal-to 10 mm, in a more extensive series, in women having IVF-embryo transfer using the same ovarian stimulation regimen. A total of 273 consecutive cycles, where endometrial thickness was greater-than-or-equal-to 10 mm, were e valuated (not including the 85 cycles previously reported). Of 22 pati ents with the hyperechogenic pattern, one achieved a chemical pregnanc y (beta-HCG >500 mIU/ml) and none achieved clinical pregnancies (ultra sound confirmation). In contrast, 67 of 251 (26.7%) patients conceived with other echo patterns (chi2 analysis = 5.9, df = 1, P = 0.01). The se data thus confirm, in a larger series, the negative influence of th is type of echo pattern on subsequent pregnancy rates following the lu teal phase leuprolide acetate-HMG ovarian stimulation regimen.