[Impact of endometric thickness on embryo implantation in vitro fecondation. a study of 414 cases]

Study of endometrial thickness is central to the monitoring of ovulation in in vitro fecondation [IVF]. Actually, failures of in vitro fecundation are mainly due to implantation failure of embryo. To assess whether the endometrial thickness the day of the induction of ovulation influences or not the result of the IVF attempt. To determine the endometrial thickness for which the chances of pregnancy are the highest. To determine if there is any effect of the stimulation protocol or the gonadotrophin on the endometrial thickness. A retrospective study at the Reproductive Medicine-Unit of Farhat Hached teaching hospital, Sousse -Tunisia, concerning all the cases of IVF conducted the year 2008. A total of 414 cycles of IVF were studied. The rate of pregnancies in our series was 23%. There was not statistically significant relation-ship between the women's-age and the endometrial thickness; nor between the rate of the ?stradiol before the IVF trial and the endometrial thickness. The endometrial thickness after ovarian stimulation was significantly linked to the rate of FSH before the IVF attempt [P = 0.01]. The total rate of pregnancies was significantly linked to the endometrial thickness before the ovulation induction [P = 0.02]. The best rate of pregnancy was reached with an endometrial thickness >12 mm [43%] and the chances of success in that case were roughly 3 times higher than if the endometrial thickness was

[ value of ambulatory hysteroscopy diagnostic. About 292 cases]

This is a retrospective study including 292 ambulatory diagnostic hyst‚roscopies realised during a period of 1 year and a half. The mid age of our patients is 44 years. The main indications are haemorrhage, infertility and abnormal ultrasound findings. The exams are carried out under analgesia. Its sensibility is good concerning the endom‚trial pathology. As a matter of fact, it equals 100% for ad‚nocarcinomas, it varies from 56.5 to 77.3% for hyperplasia, 100% for endom‚trial polyps and from 88 to 90% for endom‚trial atrophy. In contrast, it is worse for the myometrial pathology such as ad‚nomyose and sub mucosal myomas. Besides its sensibility, the tolerance of this exam allows its ambulatory realisation permitting a considerable economy