This study evaluates the correlation between ultrasound endometrial pattern in the day of hCG administration with progesterone level and IVF outcome. We included in a prospective randomised study, eighty infertile patients aged 25–35 years, BMI of 18–32 kg/m who were sent to IVF. Patients were divided in two groups after the endometrial aspect presented at ultrasound in the day of hCG: group A (forty patients) with a typical three layer endometrial pattern and group B (forty patients) who present isoechogenic or hyperechogenic endometrial pattern. Exclusion criteria were; pathogenic endometrium: polyps, adenomiosis, intracavitary fluid, submucosal myoma and endometriosis, polycystic ovary syndrome, hydrosalpinx, intramural myoma, thrombophylia, severe masculin factor necessitating ICSI. Patients underwent stimulation using gonadotropin releasing hormone (GnRH)- long agonist protocol. Clinical pregnancy rate as assessed by USS was the primary end-point and progesterone level on the day of hCG was the secondary end-point. Data were analysed by SPSS 16, results are expressed as mean ± SD, P < 0.05 was considered significant. There were no differences (P > 0.05) between groups for mean age, body mass index, total days or doses of gonadotropins, number and size of mature follicles, or sperm parameters. On the day of hCG, mean serum progesterone (1.3 versus 0.9 ng/ml, P = 0.046) level was significantly higher in group B than group A. The mean number of oocytes did not differ between the two groups (P > 0.05). Also the quality of the embryos and the number of embryos transferred was comparable for both groups (P > 0.05). Clinical pregnancy rate was higher in group A vs. group B (36.6% vs. 23.3%, P < 0.05). Biochemical pregnancy was 46.6% vs. 33.3% (P < 0.05). The incidence of miscarriage was similar 10% in both groups. On the day of hCG administration, ultrasound endometrial pattern correlates with progesterone level and IVF outcome.