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

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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.

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Weissman, A., Gotlieb, L., & Casper, R. F. (1999). The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertility and Sterility, 71(1), 147–149. https://doi.org/10.1016/S0015-0282(98)00413-0

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