Abstract
Introduction: Assisted reproductive treatment (ART) cycle like in vitro fertilization-intracytoplasmic sperm injection (IVF-ICSI) is an expensive procedure with low implantation and pregnancy rate. Endometrial pattern and thickness are suggested as the factors of endometrial receptivity and predictors of IVF-ICSI success. The correlation between endometrial pattern and thickness with pregnancy rate in IVF-ICSI cycles was evaluated in this study. Methods: In this study, 150 patients with 150 cycles were included. Ovulation induction was performed by antagonist protocol and in the day of human chorionic gonadotropin (HCG) administration, thickness and pattern of endometrium were measured by transvaginal sonography. Two weeks after embryo transfer, pregnancy rate was defined by blood HCG and the correlation between pregnancy rate with thickness and pattern of endometrium in the day of HCG administration was evaluated. Results: Pregnancy rate in triple line pattern (TLP) was significantly higher than homogenous hypoechoic pattern (P = 0.006). Endometrium thickness was significantly higher in cases of pregnancy (P < 0.001). Sensitivity and specificity of endometrium thickness > 9.5 mm in predicting pregnancy rate was 77.50% and 77.50%, respectively. In addition, the sensitivity and specificity of TLP alone or combined with endometrium thickness were 87.50%, 35.45%, 67.50% and 80.90%, respectively. Conclusion: Thickness and pattern of endometrium both could predict pregnancy occurrence. Having TLP along with endometrium thickness > 9.5 mm, the possibility of pregnancy following IVF-ICSI increases.
Highlights
Pregnancy rate in triple line pattern (TLP) was significantly higher than homogenous hypoechoic pattern (P = 0.006)
Some studies have shown that suitable thickness for implantation is between 7-14 mm and the likelihood of pregnancy is decreased in values below and above this rate
We evaluated the correlation between endometrial pattern and thickness with pregnancy rate in IVFICSI cycles
Summary
Identifying the factors affecting the endometrial receptivity could improve the outcome.[3] With proper hormonal and structural basis, endometrium will grow to appropriate thickness and would be suitable for embryo implantation.[4] Different studies have evaluated endometrial pattern and thickness as factors of endometrial receptivity and predictors of IVF-ICSI success.[5,6,7,8,9,10,11,12] Some studies have shown that suitable thickness for implantation is between 7-14 mm and the likelihood of pregnancy is decreased in values below and above this rate. We evaluated the correlation between endometrial pattern and thickness with pregnancy rate in IVFICSI cycles. All fresh IVF or ICSI treatment cycles that used gonadotropin-releasing hormone (GnRH) antagonist administration as the method of ovarian stimulation and reached oocyte pick up and embryo transfer within the study period were included, regardless of diagnosis, reproductive history, or insemination method.
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