Endometrial thickness cannot predict ongoing pregnancy achievement in cycles stimulated with clomiphene citrate for intrauterine insemination

Abstract

To date, limited data exist concerning the relation between endometrial thickness on the day of human chorionic gonadotrohin (HCG) administration and ongoing pregnancy achievement in cycles stimulated with clomiphene citrate for intrauterine insemination (IUI). In a prospective study, 168 couples were stimulated with clomiphene citrate from day 3 to day 7 of the cycle and endometrial thickness was assessed by ultrasound three times on the day of ovulation triggering. Ovulation was induced with HCG as soon as >/=1 follicle of >/=17 mm was present at ultrasound independently of endometrial thickness. IUI was performed 36 h after HCG administration. The main outcome measure was ongoing pregnancy. No difference was observed in endometrial thickness between patients who did or did not achieve an ongoing pregnancy (7.6 +/- 0.3 versus 7.6 +/- 0.2 respectively; P = 0.7). No discriminative ability of endometrial thickness on the achievement of ongoing pregnancy could be shown by receiver operating characteristic (ROC) curve analysis (area under the ROC curve 0.51, 95% CI: 0.44-0.59). In conclusion, endometrial thickness cannot predict ongoing pregnancy achievement in IUI cycles stimulated with clomiphene citrate.

The effect of administering vaginal estrogen to clomiphene citrate stimulated cycles on endometrial thickness and pregnancy rates in unexplained infertility

“…The ET for all patients together was 6 mm or less in 13.7% on the ovulation day and 3.1% on the POD7. Kolibianakis et al (13) have measured an endometrium thinner than 6 mm in 20.8%, 6-8 mm in 40.4%, and 8 mm or more in 38.6% of their cases, but did not specify the POD7 measurements. The small percentage of patients with very thin endometrium compared to the general population in our study may be a reason for the lack of a difference in pregnancy rates between the treatment groups.…”

“…The ET has been shown to remain thinner than natural cycles when CC was administered and this effect has been interpreted as the change created by CC in the estrogen receptor kinetics of the endometrium (11,12). However, there is also a study stating that even if the endometrium stays thin, this does not lead to a significant change in pregnancy rates with ET values for the 6 mm or less, 6-8 mm and 8 mm or more groups on the ovulation day at 17.1%, 19.1% and 21.5% respectively (13). These unwanted physiological effects of CC continue to be scientific areas of interest.…”

Evaluating Endometrial Thickness and Vascular Ultrasound Pattern and Pregnancy Outcomes Inintrauterine Insemination Cycle

“…Kovaces and his colleagues stated that an at least 10 mm increase in endometrial thickness is directly associated with an increased rate of pregnancy 11 . However, not all studies have delivered homogenous results and some does not yield any significant relationship between endometrial thickness and pregnancy outcome [12][13][14][15] . Weissman and his colleagues stated that implantation and pregnancy in women who had ≤ 14 mm endometrial thickness on the day of injection 16 , had a lower pregnancy rate, while Dietterich and his colleagues did not find out any harmful effect caused by endometrial thickening (mm 14 <) on the amount of implantation, pregnancy, and the abortion 17 .…”

“…This study included 100 patients, aged between 21-38 years, who referred to Shahid Akbarabadi Infertility Center during September 2013 to August 2014; the stimulation protocol was selected individually based on factors like age, diagnosis, a history of infertility, and medical condition 8 . When the diameter of the largest follicle in the follicular phase was less than 10, the patient was exposed to COH through the administration of gonadotropin with FSH or without hMG 13,14 . The initial dose of gonadotropin was between 150-450 iu and it varied based on FSH level, antral follicles, and the patient's age.…”

A comparison on the Intrauterine Insemination Outcomes of Infertile Women Undergoing Ovulation Induction with Clomiphene Citrate and rFSH

“…IUI yapılan hastalarda, preovülatuar endometrium kalınlığı ile gebelik oranları arasında literatürde farklı görüşler mevcuttur. Klomifen sitrat ile yapılan IUI sikluslarındaki preovülatuar endometrium kalınlığı ile gebelik oranlarının karşılaştırıldığı bir çalışmada ilişki olmadığı ifade edilmiştir (15). Fakat USG'de endometrial mekanik hareketlerin, hiperekoik değişimin ve trilaminar paternin gebelik öngörüsünde daha anlamlı olduğu bildirilmiştir (15,16).…”