Endometrial unresponsiveness: a novel approach to assessment and prognosis in in vitro fertilization cycles

In: Fertility and Sterility · 1996 · vol. 66(4) , pp. 604–607 · doi:10.1016/s0015-0282(16)58575-6 · PMID:8816624 · W2342562142
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This paper introduces a new method for assessing endometrial unresponsiveness and predicting outcomes in in vitro fertilization cycles.

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Abstract

ObjectiveTo categorize endometrial responsiveness to orally administered estriol in natural cycles of patients with thin endometrium. The value of endometrial responsiveness in predicting the outcome of subsequent IVF-ET cycles was evaluated.DesignProspective clinical study.SettingMiami IVF-ICSI Center, Alexandria, Egypt, a private center.PatientsForty-two patients undergoing IVF-ET. All had endometrial thickness < or = 7 mm at the time of maximal follicular diameter in natural cycle.InterventionEstriol was orally administered in subsequent unstimulated cycle. Patients were categorized into responsive and unresponsive groups (those with improved and unimproved endometrial thickness, respectively). Lastly, controlled ovarian hyperstimulation (COH) with or without estriol was started in the IVF-ET cycles.Main outcome measuresThe endometrial thickness during COH with or without estriol, fertilization, pregnancy, and abortion rates.ResultsThe responsive group compared with the unresponsive group had a significantly higher rate of improved endometrial thickness, a similar number of oocytes retrieved, a similar fertilization rate, and a significantly higher pregnancy rate.ConclusionPatients with endometrial unresponsiveness to estriol in their natural cycles rarely improve by COH and have a poor pregnancy rate in IVF cycles.

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