The relation between endometrial thickness and serum estradiol (E2)‎, progesterone levels in different protocols of controlled ovarian stimulation and its impact on intracytoplasmic sperm injection (ICSI)‎ outcome

Abstract EN

Background : Many stimulation cycles in assisted reproduction are associated with failed pregnancy despite the transfer of apparently healthy and morphologically normal embryos.

This suggests abnormal endometrial thickness in response to alteration in serum estradiol (E2) and progesterone (P) levels.

Aim: To determine the impact of serum eostrogen (E2) and progesterone levels on ICSI outcome, and to investigate the relationship between endometrial thickness measurement and its impact on ICSI outcome.

Study Design: This study was carried out on 100 infertile women who were assigned for ovarian stimulation using the different protocols applied in the Assisted Reproduction Unit in Al-Azhar University (International Islamic centre for population studies and research).All patients included in the study were subjected to:Basal serum FSH, LH & PRL were done on day 3of cycle.

Serum estradiol (E2) measurement was done basal, at day of HCG administration and at day of embryo transfer (ET).Serum progesterone measurement was done at day of embryo transfer (ET).Endometrial thickness was measured during folliculometry starting from day 7 of cycle especially at the day of HCG administration.

Results: Statistical analysis of the results show that an increase of endometrial thickness at HCG day and progesterone at ET would increase the probability of positive pregnancy by about 40% and 20% respectively.

The difference between endometrial thickness at folliculometry and at HCG day (Δ endometrial thickness) was also found to be positively and significantly associated with positive pregnancy.

Increasing the difference would increase the probability of positive pregnancy by 30% (OR= 1.30; 95% CI= 1.05 – 1.58).

Conclusion: Endometrial thickness is effective parameter for detection of ICSI outcome.Enodometrial thickness (at day of HCG) more than 9mm and less than 15mm can be used as indicator of good pregnancy outcome.