Thin endometrial stripe does not affect pregnancy outcome in clomiphene citrate/intrauterine insemination cycles

Abstract

ObjectiveImpaired endometrial development has been reported in clomiphene citrate (CC)-treated women, but its clinical relevance is uncertain. Our goal was to determine the effect of pre-ovulatory endometrial thickness (ET) on pregnancy outcome in CC /intrauterine insemination (IUI) cycles.DesignRetrospective cohort study.Materials and MethodsWe analyzed patients who underwent transvaginal ultrasound (TVU)-monitored CC/IUI and CC+single dose gonadotropin (MinStim)/IUI cycles at Mayo Clinic, between 1/2005 and 12/2012. Patients with age ≥ 40 yrs, BMI > 40 kg/m2, cycle day 3 FSH > 10 IU/ml or semen analysis with < 5 million total motile sperm (TMS) per ejaculate were excluded. A TVU was performed on CD 10, 11 or 12. The primary outcome is clinical pregnancy (CP). Clinical factors were assessed for an association with CPs using generalized estimating equations to account for correlation between multiple cycles from the same patient. The receiver operating characteristic (ROC) curve was used to assess the suitability of using ET to predict CP. SAS 9.3 was used for the analysis.ResultsTable 1Per cycle CPR according to ETET (mm)nCPR (%)ORAdjusted OR*Adjusted for age, diagnoses, CC dose, number of follicles > 15mm, endometrial pattern and TMS. # Referent group.< 615514.80.89 (0.51, 1.52)0.86 (0.48, 1.54)6 - 934916.3##> 958191.22 (0.61, 2.43)1.16 (0.56, 2.41)* Adjusted for age, diagnoses, CC dose, number of follicles > 15mm, endometrial pattern and TMS. # Referent group. Open table in a new tab ConclusionPre-ovulatory ET in CC/IUI cycles had no significant correlation with pregnancy outcome in our patient population. ObjectiveImpaired endometrial development has been reported in clomiphene citrate (CC)-treated women, but its clinical relevance is uncertain. Our goal was to determine the effect of pre-ovulatory endometrial thickness (ET) on pregnancy outcome in CC /intrauterine insemination (IUI) cycles. Impaired endometrial development has been reported in clomiphene citrate (CC)-treated women, but its clinical relevance is uncertain. Our goal was to determine the effect of pre-ovulatory endometrial thickness (ET) on pregnancy outcome in CC /intrauterine insemination (IUI) cycles. DesignRetrospective cohort study. Retrospective cohort study. Materials and MethodsWe analyzed patients who underwent transvaginal ultrasound (TVU)-monitored CC/IUI and CC+single dose gonadotropin (MinStim)/IUI cycles at Mayo Clinic, between 1/2005 and 12/2012. Patients with age ≥ 40 yrs, BMI > 40 kg/m2, cycle day 3 FSH > 10 IU/ml or semen analysis with < 5 million total motile sperm (TMS) per ejaculate were excluded. A TVU was performed on CD 10, 11 or 12. The primary outcome is clinical pregnancy (CP). Clinical factors were assessed for an association with CPs using generalized estimating equations to account for correlation between multiple cycles from the same patient. The receiver operating characteristic (ROC) curve was used to assess the suitability of using ET to predict CP. SAS 9.3 was used for the analysis. We analyzed patients who underwent transvaginal ultrasound (TVU)-monitored CC/IUI and CC+single dose gonadotropin (MinStim)/IUI cycles at Mayo Clinic, between 1/2005 and 12/2012. Patients with age ≥ 40 yrs, BMI > 40 kg/m2, cycle day 3 FSH > 10 IU/ml or semen analysis with < 5 million total motile sperm (TMS) per ejaculate were excluded. A TVU was performed on CD 10, 11 or 12. The primary outcome is clinical pregnancy (CP). Clinical factors were assessed for an association with CPs using generalized estimating equations to account for correlation between multiple cycles from the same patient. The receiver operating characteristic (ROC) curve was used to assess the suitability of using ET to predict CP. SAS 9.3 was used for the analysis. ResultsTable 1Per cycle CPR according to ETET (mm)nCPR (%)ORAdjusted OR*Adjusted for age, diagnoses, CC dose, number of follicles > 15mm, endometrial pattern and TMS. # Referent group.< 615514.80.89 (0.51, 1.52)0.86 (0.48, 1.54)6 - 934916.3##> 958191.22 (0.61, 2.43)1.16 (0.56, 2.41)* Adjusted for age, diagnoses, CC dose, number of follicles > 15mm, endometrial pattern and TMS. # Referent group. Open table in a new tab ConclusionPre-ovulatory ET in CC/IUI cycles had no significant correlation with pregnancy outcome in our patient population. Pre-ovulatory ET in CC/IUI cycles had no significant correlation with pregnancy outcome in our patient population.