Transvaginal ultrasonic assessment of endometrial growth in spontaneous and hyperstimulated menstrual cycles

Abstract

Endometrial thickness and reflectivity were a5sesced by transvaginal ultrasound in both spontaneous and hyperstimulated menstrual cycles. Two groups of women with ovulatory cycles were cxamined; women in group 1 had unexplained infertility anti women in group 2 were having artificial insemination by donor because of reduced spermatogenesis: a third group (group 3) comprised women with tuba1 infertility undergoing hyperstirnulation for in-vitro EcrtiliLation. Thcrc was no ditterence in endometrial thicknesc or reflectivity between the three groups. A basic pattern of endometrial appearance common to all cycles was found, consisting of hypoechoic, isocchoic and hyperechoic images, occurring in the early follicular, late follicular and luted phases, respectively. In all three groups a positive correlation was found between proliferative phase plasma oestradiol concentration and endometrial thickness. Group 1 r = 0403, P<O41; group 2 r = 0.439, P<O.O1; and group 3 r = 0-617, P<O41. There was a progrcscivc increase in endometrial growth throughout the normal cycle until a plateau was reached 5 days after t h e LH surge. This pattern was also sccn without acceleration of the process in hyperstimulated cycles, despite supranormal levels of oestrogcn. Assessment of endometrial thickness is not a useful variable in monitoring hyperstimulated cycles. No aberrations of endornetrial growth or pattern were observed in the wonien with unexplained infertility.

Endometrial thickness is not independent of luteal phase day in a rural Polish population

“…Even in empirical articles that report little luteal variation in ET, a clear, though qualitative, change in ET can be observed (Figure 2, Table 6). Research measuring ET serially is infrequent, but we have found articles that document ET via transvaginal ultrasound in Canadian (Baerwald and Pierson, 2004), Scottish (Randall et al, 1989), English (Raine-Fenning et al, 2004), and Swedish populations (Bakos et al, 1994). There are a few confounding problems with the serial measurements from the literature when it comes to assessing luteal endometrial function.…”

“…), Center for Human and Primate Reproductive Ecology (CHaPRE) (Randall et al, 1989) LH surge -6-10 depending on measurement day…”

Pelvic Imaging in Reproductive Endocrinology

“…Likewise, Templeton's group identified a similar sequence of changes from hypoechogenic endometrium in the follicular phase to a primarily hyperechogenic pattern in the luteal phase of stimulated cycles. 68 The sonographic changes from the follicular phase to those characteristic of the luteal phase start to be visible within 48 hours of ovulation. The hyperechoic transformation of the functional layer of the endometrium takes 4 to 7 days to complete.…”

“…[68][69][70] Prior to ovulation, the endometrium takes on a multilayered or three line appearance formed by the echogenic basal layers and the two hypoechoic functional layers, separated by the hyperechoic interphase of the virtual uterine cavity ( Fig. 35.4).…”

Assessing Uterine Receptivity in 2001

“…It is also noteworthy that endometrial thickness was not correlated with plasma E 2 levels on the day of hCG administration in the present analysis. Indeed, time‐dependent (rather than concentration‐dependent)43 thickening of the endometrium occurs throughout the follicular phase of the menstrual cycle43,45 as a probable consequence of the proliferative action of estrogens. The present data confirm the hypothesis that supraphysiological E 2 levels induced by COH do not accelerate either the pace or the magnitude of endometrial development43 beyond values triggered by physiological concentrations of estrogens.…”