The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program

Fertil Steril. 1999 Jan;71(1):147-9. doi: 10.1016/s0015-0282(98)00413-0.

Abstract

Objective: To determine whether there is a maximal value for endometrial thickness, as measured on the day of hCG administration, above which implantation and pregnancy are unlikely to occur.

Design: Retrospective analysis.

Setting: A university-based tertiary care center for assisted reproductive technology.

Patient(s): A total of 809 IVF cycles in 623 patients resulting in ET.

Intervention(s): Endometrial thickness was measured by means of transvaginal ultrasound on the day of hCG administration. Cycles were divided into two groups based on endometrial thickness. Group A consisted of 680 cycles with "normal" endometrial thickness (7-14 mm), and group B included 37 cycles with "increased endometrial thickness" (>14 mm).

Main outcome measure(s): Implantation, clinical pregnancy and miscarriage rates.

Result(s): Group B cycles had significantly lower implantation and pregnancy rates compared with group A (3% versus 15% and 8.1% versus 29.7%, respectively). Two of 3 pregnancies (66.6%) from group B miscarried, compared with 44 of 202 (21.8%) pregnancies in group A.

Conclusion(s): Patients with endometrial thickness of > 14 mm on the day of hCG administration comprise approximately 5% of the patients who undergo ET in our program. Our experience suggests that implantation and pregnancy rates are significantly reduced, and miscarriage rates may be increased in this group.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Chorionic Gonadotropin / pharmacology
  • Embryo Implantation / physiology*
  • Endometrium / anatomy & histology*
  • Estradiol / blood
  • Female
  • Fertilization in Vitro / adverse effects*
  • Humans
  • Pregnancy / physiology*
  • Pregnancy Outcome*
  • Retrospective Studies

Substances

  • Chorionic Gonadotropin
  • Estradiol