Endometrial thickness in in vitro fecundation. A 414 cases study

##plugins.themes.academic_pro.article.sidebar##

Published Dec 2, 2010
Download
pdf
Vol. 88 No. 12 (2010): Issue Dec 2010

##plugins.themes.academic_pro.article.main##

Mehdi Kehila
Sahbi Kebaili
Iheb Bougmiza
S Meddeb
Sassi Boughizane
Hedi Khairi
Mounir Ajina

Abstract

Background : 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.
Aims :
• 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.
Methods : 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.
Results : 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 ²12 mm. With ICSI (277 cases), there was a statistically significant relation-ship between endometrial thickness and the pregnancy-rate (P = 0.009). There was a statistically significant relation-ship between the endometrial thickness and the stimulation protocol used (P < 0,001) and no statistically significant relation-ship between endometrial thickness and the gonadotrophin used for ovarian stimulation (hMG or recombinant FSH).
Conclusion: There is a statistically significant relation-ship between the endometrial thickness and the success rate of ICSI attempt. A thickness higher than 12 mm seems to improve IVF results.

Keywords:

Assisted Reproductive Technologies, Embryo transfer, Endometrium, Implantation failures

##plugins.themes.academic_pro.article.details##

References

  1. B Broussin. Place de l'échographie dans l'évaluation de la qualité endométriale en Assistance médicale à la procréation (AMP). Gynecol Obstet Fertil 2007;25:570-75.
  2. G Porcu, H Déchaud, B Hédon. Réceptivité utérine et implantation embryonnaire : apport de l'échographie et du doppler dans leur évaluation en fécondation in vitro. Revue de la littérature et mise au point. j.emcgo; 2004:07-002.
  3. Noyes N, Liu HC, Sultan K, Schattman G, Rosenwaks Z. Endometrial thickness appears to be a significant factors in embryo implantation in in-vitro fertilization. Hum Reprod 1995;1: 919-22.
  4. Weissman A, Gotileb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril 1999;71: 147-9.
  5. Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril 2007;87: 53-9.
  6. Lamanna G, Scioscia M, Lorusso F, Serrati G, Selvaggi LE, Depalo R. Parabolic trend in endometrial thickness at embryo transfer in in vitro fertilization/intracytoplasmic sperm injection cases with clinical pregnancy evidence. Fertil Steril 2008;90: 1272-4.
  7. Sifer C, Cédrin-Durnerin I, Hugues JN, Poncelet C. Views of each member of an Assisted Reproductive Technologies centre on the embryo transfer procedure. Gynecol Obstet Fertil 2009;37: 645-652.
  8. Dietterich C, Check JH, Choe JK, Nazari A, Lurie D. 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. Fertil Steril 2002;77: 781-6.
  9. Zhang X, Chen CH, Confino E, Barnes R, Milad M, Kazer R. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril 2005;83: 336-40.
  10. North american ganirelix study group results of a prospective randomized, multicentric study to assess the efficacy and safety of a gonadotropin releasing hormone (GnRH) antagonist Org 37462 (Ganirelix Acetate). Treatment in women undergoing controlled ovarian hyperstimulation ASRM/CFAS Conjoin Annual Meeting, Toronto, September 25-30 1999, Abstract 028.
  11. Agameya A, Fluker M, Leader A, Claman P, Yuzepe A: Impact of GnRH antagonist of the endometrium in women undergoing IVF. ASRM/CFAS Conjoint Annual Meeting, Toronto, September 25- 30 1999.
  12. Etude MERIT : Choix des gonadotrophines pour la stimulation en FIV. J Gynecol Obstet Biol Reprod 2005; 34: 6S8-6S13.