Antiestrogenic effect of induced cycles on endometrial growth and texture

ABSTRACT

The adequacy of the induced endometrial cycles were evaluated by hormonal, sonographic and histological studies. The study was under taken at Al-Zahraa University Hospital. It included 30 infertile women in whom anovulation was suspected and proved. Serum progesterone, premenstrual endometrial biopsy and vaginal ultrasonography were done to all patients before and after clomiphene citrate [CC] therapy. All patients received CC for induction of ovulation and followed for 6 consecuative months. Whilst CC was successful in inducing ovulation in 70% of women, pregnancy only occurred in 40% by 6 months of treatment. This can be explained by decreased receptivity of the endometrium as an antiestrogenic effect of CC. There was no statistically significant difference in the endometrial thickness in periovulatory period between the out-of-phase histologic endometrium and the in-phase endometruim during CC therapy [8.8 +/- 1.8 Vs 9.8 +/- l.5][p<0.05]. But there was a statistically significant difference in the endometrial thickness in the pen-implantation period between the two groups [11.0 +/- 1.9 Vs 12.9 +/- 2.1] [p<0.05]. No trilaminar pattern III endometrial texture was observed with endometrial thickness less than 10 mm in late luteal period. Serum progesterone level [at 21st day of the cycle] of 10 ng/ml is the cut off of normal corpus luteum function