Relationship between thickness and pattern of endometrium and pregnancy rate in in vitro fertilization-intracytoplasmic

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.

Keywords: Infertility, In vitro fertilization, Endometrium Thickness, Endometrial Echo pattern, Pregnancy