Relationship of endometrial thickness and pattern to fecundity in ovulation induction cycles: effect of clomiphene citrate alone and with human menopausal gonadotropin

Richard P. Dickey, Terry T. Olar, Steven N. Taylor, David N. Curole, Ellen M. Matulich
In: Fertility and Sterility · 1993 · vol. 59(4) , pp. 756–760 · doi:10.1016/s0015-0282(16)55855-5 · PMID:8458492 · W2419667164
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Preovulation endometrial thickness, but not pattern, predicts fecundity and continuing pregnancy in ovulation induction cycles, with thinner endometria associated with lower pregnancy rates and combination hMG/CC treatment reducing thickness.

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Abstract

ObjectiveTo determine if preovulation endometrial thickness or pattern are related to fecundity and to use of clomiphene citrate (CC) or hMG in IUI.DesignProspective ultrasound evaluation the day of hCG after CC alone (n = 197), hMG alone (n = 49), concurrent hMG or sequential CC and hMG (n = 205), and no medications (n = 23).SettingPrivate fertility clinic.PatientsTwo hundred seventy-one patients undergoing 474 cycles of IUI.Main outcome measuresEndometrial thickness, pattern, per cycle fecundity, and continuing pregnancy.ResultsEndometrial thickness was related to fecundity and continuing pregnancy. No pregnancies occurred when thickness was or = 9 mm, compared with 6.9% when thickness was 6 mm to 8 mm. Endometrial pattern was unrelated to pregnancy. Average endometrial thickness was decreased when hMG and CC were used in combination (7.9 mm) compared with hMG alone (9.4 mm). Endometrial thickness was negatively related to CC dose and positively related to the day of hCG administration by ANOVA.ConclusionsEndometrial thickness the day of hCG administration is prognostic of fecundity and continuing pregnancy in cycles of ovulation induction.

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