The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program

• Published in: Fertility and sterility Vol. 71; no. 1; pp. 147 - 149
• Main Authors: Weissman, Ariel, Gotlieb, Lynda, Casper, Robert F
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1999; Elsevier Science
• Subjects: Adult; Biological and medical sciences; Birth control; Chorionic Gonadotropin - pharmacology; Embryo Implantation - physiology; Endometrial thickness; Endometrium - anatomy & histology; Estradiol - blood; Female; Fertilization in Vitro - adverse effects; Gynecology. Andrology. Obstetrics; Humans; implantation; IVF-ET; Medical sciences; pregnancy; Pregnancy - physiology; Pregnancy Outcome; Retrospective Studies; Sterility. Assisted procreation; ultrasound; Endometrial thickness; implantation; IVF-ET; ultrasound; pregnancy; Sonography; Human; Prognosis; Assisted procreation; Pregnancy; Thickness; In vitro fertilization embryo transfer; Uterus; Ovum implantation; Trophicity; Female genital system; Echography; Female; Morphometry; Endometrium
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/S0015-0282(98)00413-0

Objective: To determine whether there is a maximal value for endometrial thickness, as measured on the day of hCG administration, above which implantation and pregnancy are unlikely to occur. Design: Retrospective analysis. Setting: A university-based tertiary care center for assisted reproductive technology. Patient(s): A total of 809 IVF cycles in 623 patients resulting in ET. Intervention(s): Endometrial thickness was measured by means of transvaginal ultrasound on the day of hCG administration. Cycles were divided into two groups based on endometrial thickness. Group A consisted of 680 cycles with “normal” endometrial thickness (7–14 mm), and group B included 37 cycles with “increased endometrial thickness” (>14 mm). Main Outcome Measure(s): Implantation, clinical pregnancy and miscarriage rates. Result(s): Group B cycles had significantly lower implantation and pregnancy rates compared with group A (3% versus 15% and 8.1% versus 29.7%, respectively). Two of 3 pregnancies (66.6%) from group B miscarried, compared with 44 of 202 (21.8%) pregnancies in group A. Conclusion(s): Patients with endometrial thickness of >14 mm on the day of hCG administration comprise approximately 5% of the patients who undergo ET in our program. Our experience suggests that implantation and pregnancy rates are significantly reduced, and miscarriage rates may be increased in this group.