A method to improve false interpretation of the endometrial echo pattern as homogeneous hyperechogenic.

Endometrial echo patterns are generally evaluated and graded via transvaginal sonography; however, the uterine position can impede adequate visualization, giving the false impression of a hyperechogenic echo pattern before ovulation or oocyte retrieval. Transabdominal sonography can eliminate this error in the majority of cases when transvaginal ultrasound fails to provide diagnostic images of the endometrium.

Effect of maximal endometrial thickness on outcome after frozen embryo transfer.

The largest study to date on the association of endometrial thickness and subsequent pregnancy rates following frozen embryo transfer with the endometrium prepared by estrogen and progesterone found no improved or adverse outcome if the endometrial thickness was > or = standard deviations above the mean. Neither was there a trend noted for thin endometria.

Evaluation of a nonhomogeneous endometrial echo pattern in the midluteal phase as a potential factor associated with unexplained infertility.

OBJECTIVE: To determine whether the failure to develop a homogeneous hyperechogenic pattern in the midluteal phase is associated with decreased fecundity in infertile women who are not receiving follicle-maturing drugs. DESIGN: Observational study. SETTING: Outpatient infertility clinic of a University Medical Center. PATIENT(S): Two hundred ninety-six infertile women (> or =6 months) with regular menses, normal fallopian tubes and uterine cavity, and absence of severe male factor on their initial investigation cycle for follicular dynamic studies. INTERVENTION(S): Midluteal phase sonographic endometrial evaluation. MAIN OUTCOME MEASURE(S): Viable pregnancy rates (live fetus at end of first trimester) according to endometrial echo pattern in the midluteal phase. Other variables considered were age of patient, endometrial thickness and serum E(2) levels at midcycle and midluteal phase, midcycle echo pattern, and P levels in the midluteal phase. RESULT(S): The viable pregnancy rate was significantly higher in those women who exhibited a homogeneous hyperechogenic pattern (8.5%) compared to those women whose endometrium was found to be nonhomogenous (2.2%). No other confounding variables were found that could explain this outcome. CONCLUSION(S): A nonhomogeneous hyperechogenic sonographic endometrial echo pattern predicts lower fertility potential in women who are not receiving follicle-maturing drugs.

Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer.

OBJECTIVES: To investigate the controversy whether an increased endometrial thickness has an effect on pregnancy, implantation, or abortion rates in in vitro fertilization-embryo transfer (IVF-ET) cycles. DESIGN: Retrospective analysis. SETTING: A university-based IVF center. PATIENT(S): Five hundred seventy women under the age of 40. INTERVENTION(S): Measurements of endometrial thickness on day of human chorionic gonadotropin (hCG) administration. Cycles were compared by endometrial thickness of 14 mm in 60 women. MAIN OUTCOME MEASURE(S): Implantation, pregnancy, and abortion rates. RESULT(S): Implantation, pregnancy, and abortion rates were similar in each group. In cycles where the endometrial thickness was 14 mm. CONCLUSION(S): No adverse effects of a thickened endometrium were demonstrated on implantation, pregnancy, or abortion rates in the first IVF-ET cycle. These findings fail to corroborate with those of Weissman et al. and support those of Yakin et al.