Prognostic significance of endometrial evaluation by ultrasonography in ovulation induced cycles

OBJECTIVE: To find out prognostic significance of pre-ovulatory endometrial evaluation by ultrasound scanning after exposure to the drugs during different protocols of ovulation induction with particular reference to clomiphene citrate and to correlate with pregnancy rate.

METHODS: The thickness and texture of endometrium were the two biophysical parameters considered to be evaluated by ultrasonography. The cycles of 47 women of primary infertility were studied after ovulation induction by 4 types of protocols with or without clomiphene citrate.

RESULTS: The pregnancy rate was recorded highest (36%, 5/14) in the exclusive treatment group of clomiphene citrate protocol. Most of the women in this group suffered with low level (<6 mm) endometrial thickness, but all five women who showed A-grade endometrium became pregnant. The exclusive human menopausal gonadotrophin treated group and sequential protocol group achieved low pregnancy rates as 22% (2/9) and 27% (3,11). The luteinizing hormone releasing hormone analogue and follicle stimulating hormone protocol achieved 31% (4/13) pregnancy rate with more number of women showing A-grade endometrium quality.

CONCLUSION: The quality of endometrial texture rather than thickness of endometrium, can be considered as one of the strong prognostic factors to predict pregnancy rate in a majority of women.