Sonographic assessment of endometrial pattern and thickness in patients treated with human menopausal gonadotropins.

OBJECTIVE

To analyze sonographically the endometrium in patients undergoing controlled ovarian stimulation with menotropins in order to determine the significance of endometrial pattern and thickness on pregnancy rate.

DESIGN

This is a prospective, nonrandomized study comparing pregnancy rates in patients with hyperechoic homogeneous patterns with those in patients with isoechoic or hypoechoic trilaminar patterns.

SETTING

Tertiary infertility center.

PATIENTS

All patients receiving menotropin therapy at a tertiary infertility center.

INTERVENTIONS

All patients received individualized dosing of hMG starting on cycle day 3. Transvaginal sonography was performed 15 hours before hCG administration and the endometrium was assessed.

MAIN OUTCOME MEASURE

Occurrence of pregnancy as determined by serially rising beta-hCG titers and sonographic confirmation.

RESULTS

During the study period, 175 patients were evaluated. Thirty-four (19%) patients had a homogeneous endometrium, whereas 141 (81%) patients had a trilaminar pattern. There was 1 pregnancy (2.9%) among women with a homogeneous endometrial pattern and 33 pregnancies (23%) among those with a trilaminar pattern. No significant differences were found in mean E2 level, follicle numbers, parity, and diagnosis between the two groups.

CONCLUSION

In patients receiving menotropins, a homogeneous pattern is a bad prognostic sign, regardless of endometrial thickness.