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Journal of Assisted Reproduction and Genetics logoLink to Journal of Assisted Reproduction and Genetics
. 2004 Aug;21(8):285–289. doi: 10.1023/B:JARG.0000043701.22835.56

Significance of Increased Endometrial Thickness in Assisted Reproduction Technology Treatments

Rakefet Yoeli 1, Jacob Ashkenazi 1, Raoul Orvieto 1, Michal Shelef 1, Boris Kaplan 1, Itai Bar-Hava 1
PMCID: PMC3455437  PMID: 15568328

Abstract

Purpose: The purpose of this study was to evaluate the relationship between thick endometrium and both implantation and pregnancy rates in ART treatments.

Methods: The study group was composed of consecutive women undergoing ultrasonographic evaluation on the day of hCG administration in our ART unit. Endometrial thickness was measured at the thickest part of the midsagittal plane. On the basis of the findings, patients were divided into two groups: A—endometrial thickness >14 mm (above the 95th percentile) and B—endometrial thickness 7–14 mm (between the 5th and 95th percentiles). Patients with a thickness of less than 7 mm were excluded from the study.

Results: In all, 1218 cycles were included in the study (50 in Group A and 1168 in Group B). There was no significant difference between the groups in mean patient or mean number of embryos transferred. Similar pregnancy and implantation rates were noted in Group A (24 and 11.3%, respectively) and Group B (27.7 and 14.7%, respectively). Endometrial thickness was found to have a significant positive correlation with the duration of follicular stimulation, and an inverse correlation with woman's age.

Conclusions: Increased endometrial thickness (>14 mm) is not associated with decreased implantation or pregnancy rates in assisted reproduction.

Keywords: Implantation and pregnancy rates, thick endometrium, ultrasound

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REFERENCES

  • 1.Coulam CB, Bustilo M, Soenksen DM, Britten S. Ultrasono-graphic predictors of implantation after assisted reproduction. Fertil Steril. 1994;62:1004–1010. doi: 10.1016/s0015-0282(16)57065-4. [DOI] [PubMed] [Google Scholar]
  • 2.Noyes N, Liu HC, Sultan K, Schattman G, Rosenwaks Z. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization. Hum Reprod. 1995;10:919–922. doi: 10.1093/oxfordjournals.humrep.a136061. [DOI] [PubMed] [Google Scholar]
  • 3.Friedler S, Schenker JG, Herman A, Lewin A. The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: A critical review. Hum Reprod Update. 1996;2:323–335. doi: 10.1093/humupd/2.4.323. [DOI] [PubMed] [Google Scholar]
  • 4.Weissman A, Gotlieb 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;71:147–149. doi: 10.1016/s0015-0282(98)00413-0. [DOI] [PubMed] [Google Scholar]
  • 5.Dietterich C, Check JH, Choe JK, Nazari A, Lurie D. Increased endometrial thickness on day of human chorionic gonadotropin (hCG) injection does not ad-versely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer. Fertil Steril. 2002;77:781–786. doi: 10.1016/s0015-0282(01)03276-9. [DOI] [PubMed] [Google Scholar]
  • 6.Bar-Hava I, Ashkenazi J, Shelef M, Schwartz A, Brengauz M, Feldberg D, Orvieto R, Ben-Rafael Z. Morphology and clinical outcome of embryos after in vitro fertilization are superior to those after intracytoplasmic sperm injection. Fertil Steril. 1997;68:653–657. doi: 10.1016/s0015-0282(97)00265-3. [DOI] [PubMed] [Google Scholar]
  • 7.Remohi J, Ardiles G, Gacrcia-Velasco JA, Gaitan P, Simon C, Pellicer A. Endometrial thickness and serum estradiol concentrations as predictors of outcome in oocyte donation. Hum Re-prod. 1997;12:2271–2276. doi: 10.1093/humrep/12.10.2271. [DOI] [PubMed] [Google Scholar]
  • 8.Society for Assisted Reproductive TechnologyAmerican Society for Reproductive Medicine Assisted reproductive technology in the United States: 1997 results generated from the American Society for Reproductive Medicine/Society for Assisted Reproductive Technology Registry. Fertil Steril. 2000;74:641–653. doi: 10.1016/s0015-0282(00)01559-4. [DOI] [PubMed] [Google Scholar]
  • 9.De Geyter C, Schmitter M, De Geyter M, Nieschlag E, Holz-greve W, Schneider HP. Prospective evaluation of the ultra-sound appearance of the endometrium in a cohort of 1,186 infertile women. Fertil Steril. 2000;73:106–113. doi: 10.1016/s0015-0282(99)00484-7. [DOI] [PubMed] [Google Scholar]
  • 10.Dickey RP, Olar TT, Curole DN, Taylor SN, Rye PH. En-dometrial pattern and thickness associated with pregnancy out-come after assisted reproduction technologies. Hum Reprod. 1992;7:417–421. doi: 10.1093/oxfordjournals.humrep.a137661. [DOI] [PubMed] [Google Scholar]
  • 11.Serafini P, Batzofin J, Nesone J, Olive D. Sonographic uterine predictors of pregnancy in women undergoing ovulation induction for assisted reproductive treatments. Fertil Steril. 1994;45:815–822. doi: 10.1016/s0015-0282(16)57010-1. [DOI] [PubMed] [Google Scholar]
  • 12.Oliveira JB, Baruffi RLR, Mauri AL, Petersen CG, Borges MC, Franco JG., Jr Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization program after ovar-ian stimulation and gonadotrophin-releasing hormone and go-nadotrophins. Hum Reprod. 1997;12:2515–2518. doi: 10.1093/humrep/12.11.2515. [DOI] [PubMed] [Google Scholar]
  • 13.Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. J US Obstet Gynecol. 2001;18:258–263. doi: 10.1046/j.1469-0705.2001.00502.x. [DOI] [PubMed] [Google Scholar]
  • 14.Gonen Y, Casper RF, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: A possible predictor of implantation in in vitro fertilization. Fertil Steril. 1989;52:446–450. doi: 10.1016/s0015-0282(16)60916-0. [DOI] [PubMed] [Google Scholar]
  • 15.Sher G, Herbert C, Maassarani G, Jacobs MH. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF/ET) Hum Reprod. 1991;6:232–237. doi: 10.1093/oxfordjournals.humrep.a137312. [DOI] [PubMed] [Google Scholar]
  • 16.Oliveira JB, Baruffi RLR, Mauri AL, Petersen CG, Campos MS, Franco JG., Jr Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilization programme. Hum Reprod. 1993;8:1312–1315. doi: 10.1093/oxfordjournals.humrep.a138248. [DOI] [PubMed] [Google Scholar]
  • 17.Schild RL, Knobloch C, Dorn C, Fimmers R, van der Ven H, Hansmann M. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endome-trial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril. 2001;75:361–366. doi: 10.1016/s0015-0282(00)01695-2. [DOI] [PubMed] [Google Scholar]
  • 18.Rinaldi L, Lisi F, Floccari A, Lisi R, Pepe G, Fishel S. Endome-trial thickness as a predictor of pregnancy after in-vitro fertilization but not after intracytoplasmic sperm injection. Hum Reprod. 1996;11:1538–1541. doi: 10.1093/oxfordjournals.humrep.a019434. [DOI] [PubMed] [Google Scholar]
  • 19.Bar-Hava I, Yoeli R, Ashkenazi J, Orvieto R, Meizner I, Shalev J, Sherizli I, Perri T, Ben-Rafael Z: Simultaneous multi-gated spectral Doppler imaging-A novel independent tool to explore uterine receptivity. Paper presented at the Annual Meeting of the American Society for Reproductive Medicine (ASRM), Toronto, Canada, 1999 (O-148)
  • 20.Yoeli R, Feldberg D, Orvieto R, Ashkenazi J, Perri T, Chen R, Meizner I, Shalev J, Ben-Rafael Z, Bar-Hava I.Perfusion index: A novel parameter for evaluation of uterine receptivity in assisted reproduction Hum Reprod 2000153011041219 [Google Scholar]
  • 21.Spandorfer SD, Arrendondo-Soberon F, Loret de Mola JR, Feiberg RF. Reliability of intraobserver and interobserver sonographic endometrial stripe thickness measurements. Fertil Steril. 1998;70:152–154. doi: 10.1016/s0015-0282(98)00101-0. [DOI] [PubMed] [Google Scholar]

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