Transvaginal sonographic evaluation of endometrial growth and texture in spontaneous ovulatory cycles—a descriptive study

Abstract

Repeated transvaginal ultrasonographic examinations were performed during spontaneous ovulatory cycles to follow the texture and growth pattern of the endometrium in 23 healthy volunteers. The serum concentrations of oestradiol, progesterone and luteinizing hormone (LH) were measured regularly. The day of the LH peak was designated as day 0. On ultrasound only one thin echogenic line was seen from menstruation to day -7. From days -6 to -1 a change from one to three thin lines was observed together with an increasing hypoechogenic texture between the lines. These changes corresponded to the increasing serum concentration of oestradiol and increasing thickness of the endometrium. At ovulation there was maximum hypoechogenic texture between the lines which had become thicker. At ovulation the endometrium had a mean thickness (both layers) of 12 mm. From days +1 to +6 an increasing blurring of the three lines became apparent and the previously hypoechogenic layers gradually displayed a more echogenic texture. From day +7 to menstruation the lines were indistinguishable due to the appearance of a general hyperechogenic texture of the endometrium. In the luteal phase the growth of the endometrium plateaued. The results indicate that ultrasound assessment of endometrial growth and texture may be an important tool to evaluate normal ovulatory endometrial development. It can also be useful in monitoring stimulated cycles in different treatment modalities of assisted reproduction.

Prediction of pregnancy in artificial reproductive techniques through evaluation of thickness, morphology and vascularity of endometrium

“…12 However, since a correlation between echogenicity and progesterone has not been demonstrated, other factors such as androgen and gonadotropin effects could explain these changes. 13 In our research, all cases who achieved pregnancy had a triple-line pattern of the endometrium on day of HCG. In eight cases, there was gapping between the endometrium and fluid inside, and none of these cases achieved pregnancy.…”

Transvaginal Ultrasonographic Evaluation of the Endometrium Related to the Histological Findings in Pre- and Perimenopausal Women

“…The usefulness of ultrasonography in the endometrial diagnostic has been described earlier, both in natural ovulatory cycles [14] and in therapeutic monitoring [15,16]. Furthermore, it has been shown that the transvaginal technique is superior to the transabdominal technique, because of its better imaging qualities using higher frequencies [8,9,17].…”

“…Both machines were equipped with a 5.0-MHz vaginal transducer with a scanning sector of 90° and a focal range of the transducer of 8 cm. Details about the method of examination and measurements were published earlier [14].…”

“…In the pre-and perimenopausal age group an endometrial thickness of 10 mm or more was tested as a parameter for the discrimination value of endometrial pathology. The 10-mm cutoff point of the endometrial thickness was chosen from the knowledge of the endometrial evolution in the fertile age group, reaching a mean maximal thickness of 10-12 mm at the ovulation time [14].…”

The Role of Ultrasound in the Evaluation of Endometrial Receptivity Following Assisted Reproductive Treatments

“…During the secretory phase of the menstrual cycle, the endometrium acquires a hyperechogenic morphology that is due to stromal edema, spirilization and secretion of the endometrial glands caused by the action of progesterone (Bassil et al, 2001;Fanchin et al, 2000;Fanchin et al, 2001;Leibovitz et al, 1999). However, since a correlation between echogenicity and progesterone has not been demonstrated (Bakos et al, 1993;Khalife et al, 1992) other factors such as androgen and gonadotropin effects could explain these changes (De Ziegler and Fancin, 1994;Tang and Gurpide, 1993).…”