Objective To evaluate the outcome of in vitro fertilization (IVF) treatment in relation to the sonographic parameters of the endometrium. Design and methods

A computer program was developed to assess the endometrial echogenicity relative to the myometrial one, based on the gray-level processing of the midsagittal uterine image. The endometrial region of interest was specified within the upper part of the uterine cavity. The adjacent area of the myometrium was used to determine the reference brightness. The endometrial region of interest was analyzed along the anteroposterior uterine axis, as a set of thin strips directed parallelly to the midcavitary line. The endometrial/myometrial relative echogenicity coefficient (E/M REC) was computed for each strip and displayed graphically as a function of the distance from the midcavitary line. The area under the E/M REC curve within the limits of the total endometrial width was defined as total area (TA) and was used as a measure of the endometrial echogenicity. This parameter was assessed in 9 patients during their normal ovulatory cycles and in 29 IVF-treated patients with mechanical infertility. TA has a significant linear increase during the days of the ovulatory cycles. TA was found in high correlation with log(estradiol). TA can be used reliably for sonographic endometrial dating in ovulatory cycles.

Doppler flow studies of the intracranial internal carotid artery and middle cerebral artery performed in 17 women at 30–36 weeks of gestation, referred for evaluation of small for gestational age fetuses, resulted in abnormally low pusatility index values (below 2 SD). These patients were investigated when fasting and 1 h after a 100-gram glucose load. Increase of 20 ml/dl or more was followed by elevation of the mean pulsatility index in the internal carotid artery from 1.03 ± 0.09 to 1.44 ± 0.22 (p < 0.001), and in the middle cerebral artery from 1.12 ± 0.16 to 1.83 ± 0.24 (p < 0.001). Pulsatility index values returned to normal (within 2 SD for gestational age) in 15 of the subjects investigated after glucose load. These findings suggest the importance of standard fasting state or determination of maternal plasma glucose levels in patients undergoing Doppler flow evaluation of growth-retarded fetuses.