Non-homogeneous hyperechogenic pattern 3 days after embryo transfer is associated with lower pregnancy rates

The purpose of this study was to investigate the relationship between mid-l uteal phase echo patterns and IVF-embryo transfer outcome in women who have demonstrated adequate endometrial development by the late proliferative ph ase. A prospective study was carried out of 86 patients undergoing IVF-embr yo transfer and 86 patients undergoing frozen embryo transfer who all under went sonographic monitoring of the endometrium 3 days after embryo transfer . The cycles were classified into two groups: those with the homogeneous hy perechogenic (HH) pattern and those without it. The women who had an HH pat tern had higher clinical pregnancy (32.8 versus 10.7%, P < 0.05) and implan tation rates in stimulated cycles (14.3 versus 4.1%, P < 0.05 respectively) than those that did not. There was no significant difference in the clinic al pregnancy or implantation rates by echo pattern (18.2 and 8.1% for non-H H and 18.7 and 8.0% for HH respectively) in frozen embryo transfer cycles. These data demonstrate that in embryo transfer cycles where ovarian stimula tion was used, there were decreased pregnancy and implantation rates in cyc les where the HH pattern was not observed 3 days after transfer. The failur e of the endometrium to display this pattern may indicate some endometrial abnormality resulting in implantation defects.