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[Sonographic evaluation of endometrial preparation with oral estrogen-progesterone substitution before cryogenic
I Oborná1, J Dostál, J Brezinová
1Gynekologicko-porodnická klinika LF UP a FN, Olomouc.
Objective:
To compare the changes of sonographic features of endometrium throughout natural and artificial cycles in which oral estrogen-progesterone substitution were used in the same group of patients and discuss their clinical significance.
Design:
A prospective study.
Setting:
Dept. of Obstetrics and Gynaecology, University Hospital, Olomouc.
Methods:
In 24 women with regular menstrual cycle ovulation was detected (LH, sonography) and the following sonographic features: endometrial thickness, echogenity and pulsatility index (PI) of uterine artery were evaluated in the late proliferative, early and mid secretory phase. The same sonographic examination was performed in the artificial cycle with oral estrogen-progesterone substitution used for endometrial preparation for transfer of cryopreserved-thawed embryos.
Results:
In the late proliferative phase of the natural cycle the thickness of endometrium was higher than in the arteficial cycle (p=0.05). Triple-line echogenity prevailed in both cycles. The PI in natural cycle was lower (p=0.01) on the side of the growing Graafian follicle compared to the other side and lower (p=0.05) than in the artificial cycle. In the secretory phase there were no differences in endometrial thickness within cycles. Homogenous hyperechoic endometrium prevailed in both cycles and the lowest PI was found on the 7th day both after ovulation and after initiation of progesterone substitution.
Conclusion:
Progesterone addition after endometrial preparation with estrogen should be instituted when the endometrium thickness reached at least 9mm and isoechoic or triple line echogenity is found.
