Endometrial thickness was measured ultrasonographically in three groups of patients undergoing in-vitro fertilization (IVF) on three different ovulation induction regimens. The endometrial thickness was comparable on all three regimens and similar to that observed in a group of spontaneously ovulating, normal, fertile controls. These patterns of endometrial thickness were observed despite significantly higher levels of serum oestradiol-17 beta in all of the hyperstimulated cycles, suggesting that in the normal cycle a maximum response in terms of endometrial development may be achieved. In the three conception cycles endometrial thickness continued to increase throughout the luteal phase, whilst in non-conception cycles plateauing of thickness increase occurred in the mid-luteal phase and reduction in late luteal phase. Whether ultrasonographic evaluation of endometrium during IVF stimulation cycles has any prognostic value regarding prediction of conception has yet to be determined.

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We conclude that 1,2-propanediol can be used with success in oocyte cryopreservation, although the issue of parthenogenecity is still to be resolved. Oocyte's with intact cumulus survive cryostorage better than those without it.

In this study, we report an alternative method of management of patients at a potential risk of ovarian hyperstimulation syndrome (OHSS) in an in-vitro fertilization (IVF) programme, by the use of gonadotrophin releasing hormone analogue (GnRHa). Thirty eight women considered at risk of this syndrome, having serum oestradiol greater than 4000 pg/ml following ovarian stimulation, received a GnRHa nasal spray for induction of the preovulatory endogenous luteinizing hormone surge for follicular maturation prior to oocyte recovery. Oocyte recovery (mean oocytes per cycle 18.60 +/- 4.79; range 15-35) and IVF were successfully completed in 27 cycles. Twenty six women had embryos replaced and 11 pregnancies occurred (28.9% per operation, 42.3% per replacement cycle). None of the patients developed OHSS. Where there is a risk of OHSS, the use of GnRHa to induce the preovulatory surge of endogenous luteinizing hormone for final follicular maturation provides a successful and more economical alternative to cancellation of cycles.

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