Efficacy of estradiol supplement therapy for patients with thin endometrium in intrauterine insemination cycles / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: To evaluate the endometrial response and to compare the pregnancy outcome of estradiol supplement in patients with abnormally thin endometrium who are undergoing IUI. METHODS: From November 1st, 1998 to February 28th, 2001, 914 IUI cycles were studied and which were divided into several groups. In preparatory cycle, all of the patients were prepared with conjugated estrogen. The patients were divided into several groups according to the endometrial thickness (ET). Control I (n=734) was normal control group (ET>or=7 mm). Control II (n=67) was control group with abnormally thin endometrium (ETintrauterine insemination7 mm) without estradiol supplement. Group I (n=65) and group II (n=48) had thin endometrial thickness. However, in preparatory cycle, the endometrial thickness was more than 7 mm in group I and was less than 7 mm in group II. Uterine preparation consisted of 6-8 mg of estradiol valerate. The number of natural cycle was 234 and the hyperstimulation protocol used were clomiphene (n=250), clomiphene/ hMG (n=214), hMG (n=216). RESULTS: The average pregnancy rate in group I was 15.4%. There was no significant difference between control I (21.1%) and group I. The pregnancy rate in control II and group II was significantly decreased (3.0 vs. 6.3%) compared with control I and group I. In control I and group I, average endometrial thickness and pregnancy rate were decreased when clomiphene was used compared with hMG alone. (endometrial thickness control I 8.4 +/- 0.6 vs. 10.0 +/- 0.7 mm, group I 6.9 +/- 0.8 vs. 7.9 +/- 0.7 mm, pregnancy rate control I 14.6 vs. 29.8%, group I 9.1 vs. 31.3%). CONCLUSION: The adequate endometrial thickness is an important prognostic factor for implantation and is achieved with administration of estradiol supplement in patients with abnormally thin endometrium who responded to exogenous estradiol with endometrial thickness up to 7 mm in evaluation cycle.