Die sonographische Endometriumdicke als Prediktionsfaktor für eine Schwangerschaft in einem IVF-Programm

Zusammenfassung

Studienziel: Die Evaluation der Rolle der transvaginalsonographischen Dickenmessung des Endometriums bei IVF-Patientinnen. Methode: In einer prospektiven Studie wurden bei 936 Zyklen (722 Patientinnen) transvaginale Endometriumdickenmessungen am Tag der Reifungsspritze durchgeführt. Ergebnisse: Die Schwangerschaftsrate war 31,1 % (291/936). Das Alter (p < 0,029), die Anzahl der transferierten Embryos (p < 0,004), der Östradiolspiegel am Tag der Reifungsspritze (p < 0,04) und die Embryoqualität (p < 0,002) waren bei den Schwangeren signifikant unterschiedlich. Die mittlere Endometriumdicke (± SD) aller Patientinnen war 11,16 mm (± 2,13). Die mittlere Endometriumdicke (± SD) der Schwangeren war 11,35 mm (± 2,19). Die mittlere Endometriumdicke (± SD) der Nichtschwangeren war 11,12 (± 2,10). Die Regressionsanalyse zeigte keinen signifikanten Unterschied zwischen Schwangeren und Nichtschwangeren (p < 0,23). Schlußfolgerung: Am Tag der Reifungsspritze kann durch die sonographische Dickenmessung des Endometriums die Schwangerschaft nicht vorhergesagt werden.

Abstract

Aim: This prospective study was performed to evaluate the predictive value of endometrium thickness in patients undergoing IVF-ET. Method: Measurements of endometrium thickness as well as pattern assessments were performed in 936 cycles (722 patients) on the day of administering human chronic gonadotropin (HCG). Results: The overall pregnancy rate was 31.1 % (291/936). The age of non pregnant patient was significantly higher (p < 0.029). There was a significant influence of oestradiol (p < 0.029), number of transferred embryos (p < 0.004), and embryo quality (p < 0.002) on the pregnancy rate. Overall, the mean (± SD) endometrium thickness was 11.16 mm (± 2.13). The mean (± SD) endometrium thickness of pregnant patients was 11.25 mm (± 2.19). The mean (± SD) endometrium thickness of non-pregnant patients was 11.12 mm (± 2.10). A stepwise logistic regression analysis showed no statistically significant correlation between endometrium thickness and pregnancy rate (p < 0.23). Conclusion: Sonographic measurement of endometrium thickness on the day of human chorionic treatment with gonadotropin is not useful in predicting IVF outcome.

Transvaginalultraschall - Endometriumdicke - Implantation - Schwangerschaftsrate - IVF

Transvaginal ultrasound - Endometrium thickness - Implantation - Pregnancy rate - IVF

Literatur

• 1 Gonen Y, Casper R F, Jacobson W, Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilisation.  Fertil Steril. 1989;  52 446-450
• 2 Bergh C, Hillensjo T, Nilson L. Sonographic evaluation of the endometrium in in vitro fertilisation IVF cycles. A way to predict pregnancy?.  Acta Obstet Gynecol Scand. 1992;  71 624-628
• 3 Dickey R P, Olar T T, Curole D N, Taylor S N, Rye P H. Endometrial pattern and thickness associated with pregnancy outcome after assisted reproduction technologies.  Hum Reprod. 1992;  7 418-421
• 4 Abdalla H, Brooks A A, Johnson M R, Kirkland A, Thomas A, Studd J W. Endometrial thickness: a predictor of implantation in ovum recipients?.  Hum Reprod. 1994;  9 363-365
• 5 Noyes N, Liu H C, Sultan K, Schattman G, Rosenwaks Z. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilisation.  Hum Reprod. 1995;  10 919-922
• 6 De Geyter C, Schmitter M, De Geyter M, Nieschlag E, Holzgreve W, Schneider H P. Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1 186 infertile women.  Fertil Steril. 2000;  73 106-113
• 7 Coulam C B, Bustillo M, Soenksen D M, Britten S. Ultrasonographic predictors of implantation after assisted reproduction.  Fertil Steril. 1994;  62 1004-1010
• 8 Oliveira J BA, Baruffi R LR, Mauri A L, Petersen C G, Borges M C, Franco J G. Endometrial ultrasonography as a predictor of pregnancy in an in-vitro fertilisation program after ovarian stimulation and gonadotropin-releasing hormone and gonadotropins.  Hum Reprod. 1997;  12 2515-2518
• 9 Remohi J, Ardiles G, Garcia-Velasco J A, Gaitan B, Simon C, Pellicer A. Endometrial thickness and serum oestradiol as predictors of outcome in oocyte donation.  Hum Reprod. 1997;  12 271-276
• 10 Friedler S, Schenker J G, Herman A, Lewin A. The role of ultrasound in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review.  Hum Reprod Update. 1996;  2 323-335
• 11 Yaman C, Ebner T, Sommergruber M, Pölz W, Tews G. The role of three dimensional ultrasound in predicting outcome in an ivf program: a preliminary study.  Fertil Steril. 2000;  74 781-797
• 12 Strohmer H, Obruca A, Radner K M, Feichtinger W. Relationship of the individual uterine size and the endometrial thickness in stimulated cycles.  Fertil Steril. 1994;  61 972-975
• 13 Spandorfer S D, Arrendondo-Soberon F, Loret de Mola J R, Feimberg R F. Reliability of intraobserver and interobserver sonographic endometrial stripe thickness measurements.  Fertil Steril. 1998;  70 152-154