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Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone
J D Isaacs1, C S Wells, D B Williams
1Washington University School of Medicine, Department of Obstetrics and Gynecology, St. Louis, Missouri, USA.
Objective:
To evaluate the ability of an ultrasound (US)-measured periovulatory endometrial thickness to predict conception in hMG-stimulated cycles.
Design:
Retrospective.
Setting:
A university-based tertiary practice.
Patients:
One hundred twelve patients undergoing 292 cycles of ovulation induction with hMG alone.
Main Outcome Measures:
A periovulatory transvaginal US measurement of endometrial thickness was obtained during cycles of ovulation induction with hMG alone. Clinical pregnancy was defined by fetal cardiac activity. Sensitivity and false-positive rates for multiple discriminatory values of endometrial thickness were calculated and a relative operating characteristic (ROC) curve was constructed to evaluate the performance of this test as a predictor of pregnancy.
Results:
Thirty-eight of 292 cycles resulted in pregnancy. Conception and nonconception cycles showed similar demographics, diagnoses, peak E2, maximum number of follicles, midluteal P, and mean endometrial thickness. Ovulatory dysfunction was a more frequent diagnosis in the conception group. Relative operating characteristic analysis for endometrial thickness as a predictor of pregnancy yielded an area under the curve of 0.623 +/- 0.049 (mean +/- SD).
Conclusion:
Endometrial thickness is a valid screening test for conception outcome in cycles stimulated with hMG. A periovulatory endometrial thickness > or = 10 mm defined 91% of conception cycles. No pregnancy occurred when the endometrium measured < 7 mm.