Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme

The endometrial pattern and thickness were analysed by ultrasonography in 139 cycles stimulated for in-vitro fertilization (IVF) on the day of administration of human chorionic gonadotrophin (HCG). A semi-programmed schedule based on the pill + clomiphene citrate + human menopausal gonadotrophin (HMG) was used in all cycles. On the day of HCG administration, endometrial pattern and thickness were assessed with an Ultramark 4 (ATL) ultrasound equipped with a 5 MHz vaginal probe. Endometrial pattern I (a 'triple-line' multilayer) was observed in a total of 105 cycles (76%), and pattern II (fully homogeneous and hyperechogenic in relation to myometrial tissue) in 34 (24%). The incidence of clinical pregnancy did not differ (P = 0.52) between the groups with endometrial patterns I (23.8%) and II (29.4%). Endometrial thickness on the day of HCG administration in the group with pattern I (8.4 +/- 1.9 mm) was similar (P = 0.96) to that observed in the group with pattern II (8.4 +/- 2.0 mm). In addition, the endometrial thickness of the patients who became pregnant (8.0 +/- 1.7 mm) did not differ (P = 0.15) from that of women who did not achieve pregnancy (8.6 +/- 2.0 mm). The conclusion from the present data is that ultrasonographic analysis of endometrial thickness and refringency on the day of HCG administration had no predictive value for conception in IVF cycles.