Artificial insemination - Role of endometrial thickness and pattern, of vascular impedance of the spiral and uterine arteries, and of the dominant follicle

OBJECTIVE: To assess the roles of endometrial thickness and pattern, as wel l as vascular impedance of the spiral and uterine arteries and dominant fol licle in predicting the pregnancy rate in women receiving controlled ovaria n hyperstimulation (COH) following by intrauterine insemination (IUI). STUDY DESIGN: All idiopathically infertile couples who accepted COH + IUI f or the first time were prospectively included. The COH agents included clom iphene citrate and human menopausal gonadotropins. Endometrial thickness an d pattern (trilaminar, nontrilaminar) and vascular impedance (pulsatility i ndex [PI] resistance index [RI]) of the spiral and uterine arteries and ova rian dominant follicle were measured oil the day of IUI. Analyses were made of the influences on pregnancy outcomes by endometrial thickness and patte rn as well as Doppler surveys of the spiral and uterine arteries and domina nt follicle. RESULTS: A total of 110 couples with 120 cycles were enrolled, and there we re 16 resulting pregnancy cycles. Trilaminar endometrium appeared in 87.5% and 57.4% of pregnant and nonpregnant women (P = .022), respectively. The p regnancy rates in trilaminar and nontrilaminar groups were 17.9% and 6.3%, respectively (P = .022). Endometrial thickness and PI/RI values for the spi ral artery and uterine arteries and dominant follicle in pregnant women (12 .1 +/- 12.6; 1.28 +/- 0.33/0.68 +/- 0.12; 2.67 +/- 0.51/0.72 +/- 0.32; 0.72 +/- 0.19/0.54 +/- 0.06 mm, respectively) were not statistically different from those for non pregnant women (11.0 +/- 2.9; 1.46 +/- 0.49/0.71 +/- 0.2 1; 2.81 +/- 0, 65/0.88 +/- 0.34; 0.74 +/- 0.24/0.55 +/- 0.09, respectively) . CONCLUSION: A trilaminar endometrium on the day of IUI provides a favorable prediction of pregnancy. Endometrial thickness and Doppler surveys of the spiral and uterine arteries and dominant follicle do not have useful predic tive value in COH + IUI.