Hysteroscopic appearance of the mid-secretory endometrium: relationship toearly phase pregnancy outcome after implantation

A total of 172 patients who underwent hysteroscopic assessment of the endom etrium and then became pregnant, was analysed retrospectively to explore th e relationship between endoscopic findings and early phase pregnancy outcom e after implantation. Histological examination of the endometrium and assay of serum progesterone and oestrogen were carried out simultaneously with h ysteroscopy, Of 172 patients, 12 were excluded. Of the remaining 160 patien ts, 62 (38.8%) were classified endoscopically as having 'good' mid-secretor y endometrium and 98 (61.3%) as 'poor', between one and four cycles prior t o the conception cycle. There were no clinical differences between these tw o groups, except that the frequency of patients with a history of early abo rtion was significantly higher in the 'poor' group (25.5%) than in the 'goo d' group (8.1%) (P < 0,05), Of 160 pregnancies, 118 persisted successfully to live birth, but 42 ended in early pregnancy loss, The incidence of early abortion was significantly higher in the 'poor' group (33.7%) than in the 'good' group (14.5%) (P < 0,05), Significant differences were observed betw een the two groups for histological dating of the endometrium (P < 0.05) bu t not for serum progesterone and oestradiol concentrations or progesterone: oestradiol ratio. In conclusion, our data suggest that the hysteroscopic ap pearance of the mid-secretory endometrium at this stage of the menstrual cy cle is a better prognostic factor for pregnancy outcome than hormonal data.