Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles

  • Matthew A. BarkerEmail author
  • Lynn M. Boehnlein
  • Peter Kovacs
  • Steven R. Lindheim



To study the effect of endometrial thickness (ET) and echogenic pattern (EP) in oocyte donation cycles upon pregnancy outcomes.


Seventy-nine cycles resulting in blastocyst embryo transfer were evaluated. Donors underwent ovarian hyperstimulation using rFSH and GnRH-antagonist. Recipients were synchronized to donors using GnRH-agonist down-regulation followed by fixed dose of estrogen (E2) and progesterone (P4) following hCG. Transvaginal ultrasound (US) obtained ET and EP 10-11 days after initiation of E2 and on day of embryo transfer. Primary outcome was ET and EP in pregnant and non-pregnant cycles. Stimulation and embryology data was analyzed in donors to assess differences prior to transfer.


Fifty-nine cycles resulted in clinical pregnancy. No differences were observed in pregnant vs. non-pregnant cycles in proliferative or secretory ET and EP. Similar baseline and stimulation characteristics were found in pregnant and non-pregnant cycles. Regression analysis showed end thickness were not predictive of pregnancy outcomes.


Endometrial characteristics in recipients prior to and following progesterone were not predictive of pregnancy outcomes.


Blastocyst Embryo transfer Endometrial thickness and pattern Oocyte donation 



The authors do not have any financial grants or other outside funding for this study. None of the authors have any conflict of interests.


  1. 1.
    McWilliams GD, Frattarelli JL. Changes in measured endometrial thickness predict in vitro fertilization success. Fertil Steril. 2007;88(1):74–81. doi: 10.1016/j.fertnstert.2006.11.089.PubMedCrossRefGoogle Scholar
  2. 2.
    Amir W, Micha B, Ariel H, Liat LG, Jehoshua D, Adrian S. Predicting factors for endometrial thickness during treatment with assisted reproductive technology. Fertil Steril. 2007;87(4):799–804. doi: 10.1016/j.fertnstert.2006.11.002.PubMedCrossRefGoogle Scholar
  3. 3.
    Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1, 294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril. 2007;87(1):53–9. doi: 10.1016/j.fertnstert.2006.05.064.PubMedCrossRefGoogle Scholar
  4. 4.
    Zhang X, Chen CH, Confino E, Barnes R, Milad M, Kazer RR. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril. 2005;83(2):336–40. doi: 10.1016/j.fertnstert.2004.09.020.PubMedCrossRefGoogle Scholar
  5. 5.
    Zenke U, Chetkowski RJ. Transfer and uterine factors are the major recipient-related determinants of success with donor eggs. Fertil Steril. 2004;82(4):850–6. doi: 10.1016/j.fertnstert.2004.03.057.PubMedCrossRefGoogle Scholar
  6. 6.
    Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod. 2003;18(11):2337–41. doi: 10.1093/humrep/deg461.PubMedCrossRefGoogle Scholar
  7. 7.
    Noyes N, Hampton BS, Berkeley A, Licciardi F, Grifo J, Krey L. Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis. Fertil Steril. 2001;76(1):92–7. doi: 10.1016/S0015-0282(01) 01823-4.PubMedCrossRefGoogle Scholar
  8. 8.
    Sharara FI, Lim J, McClamrock HD. Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration. J Assist Reprod Genet. 1999;16(10):523–8. doi: 10.1023/A:1020545120256.PubMedCrossRefGoogle Scholar
  9. 9.
    Rashidi BH, Sadeghi M, Jafarabadi M, Tehrani Nejad ES. Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern. Eur J Obstet Gynecol Reprod Biol. 2005;120(2):179–84. doi: 10.1016/j.ejogrb.2004.08.016.PubMedCrossRefGoogle Scholar
  10. 10.
    Schild RL, Knobloch C, Dorn C, Fimmers R, van der Ven H, Hansmann M. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril. 2001;75(2):361–6. doi: 10.1016/S0015-0282(00) 01695-2.PubMedCrossRefGoogle Scholar
  11. 11.
    Laasch C, Puscheck E. Cumulative embryo score, not endometrial thickness, is best for pregnancy prediction in IVF. J Assist Reprod Genet. 2004;21(2):47–50. doi: 10.1023/B:JARG.0000025937.43936.73.PubMedCrossRefGoogle Scholar
  12. 12.
    Garcia-Velasco JA, Isaza V, Caligara C, Pellicer A, Remohí J, Simón C. Factors that determine discordant outcome from shared oocytes. Fertil Steril. 2003;80(1):54–60. doi: 10.1016/S0015-0282(03)00545-4.PubMedCrossRefGoogle Scholar
  13. 13.
    Dietterich C, Check JH, Choe JK, Nazari A, Lurie D. Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer. Fertil Steril. 2002;77(4):781–6. doi: 10.1016/S0015-0282(01)03276-9.PubMedCrossRefGoogle Scholar
  14. 14.
    Yuval Y, Lipitz S, Dor J, Achiron R. The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization. Hum Reprod. 1999;14(4):1067–71. doi: 10.1093/humrep/14.4.1067.PubMedCrossRefGoogle Scholar
  15. 15.
    Sundström P. Establishment of a successful pregnancy following in-vitro fertilization with an endometrial thickness of no more than 4 mm. Hum Reprod. 1998;13(6):1550–2. doi: 10.1093/humrep/13.6.1550.PubMedCrossRefGoogle Scholar
  16. 16.
    Tang B, Gurpiode E. Direct effect of gonadotropins on decidualization of human endometrial stroma cells. J Steroid Biochem Mol Biol. 1993;47:115–21. doi: 10.1016/0960-0760(93) 90064-4.PubMedCrossRefGoogle Scholar
  17. 17.
    Paulson RJ, Sauer MV, Lobo RA. Embryo implantation after human in vitro fertilization: importance of endometrial receptivity. Fertil Steril. 1990;53:870–4.PubMedGoogle Scholar
  18. 18.
    Fanchin R, Righini C, Olivennes F, Ferreira AL, de Ziegler D, Frydman R. Consequences of premature progesterone elevation on the outcome of in vitro fertilization: insights into a controversy. Fertil Steril. 1997;68:799–805. doi: 10.1016/S0015-0282(97)00337-3.PubMedCrossRefGoogle Scholar
  19. 19.
    Coulam CB, Bustillo M, Soenksen DM, Britten S. Ultrasonographic predictors of implantation after assisted reproduction. Fertil Steril. 1994;62:1004–10.PubMedGoogle Scholar
  20. 20.
    Noyes RW, Hertig AT, Rock J. Dating the endometrial biopsy. Fertil Steril. 1950;1:3.Google Scholar
  21. 21.
    Noci I, Borri P, Chieffi O, Scarsselli G, Biaglotti R, Moncini D, et al. Aging of the human endometrium: a basic morphological and immunohistochemical study. Eur J Obstet Gynecol Reprod Biol. 1995;63:181–5. doi: 10.1016/0301-2115(95)02244-9.PubMedCrossRefGoogle Scholar
  22. 22.
    Paulson RJ, Sauer MV, Lobo RA. Potential enhancement of endometrial receptivity in cycles using controlled ovarian hyperstimulation with antiprogestins: a hypothesis. Fertil Steril. 1997;67:321–5. doi: 10.1016/S0015-0282(97)81918-8.PubMedCrossRefGoogle Scholar
  23. 23.
    Castelbaum AJ, Ying L, Somkuti SG, Sun J, Ilesanni AO, Lessey BA. Characterization of integrin expression in well differentiated endometrial a endometrial adenocarcinoma cell line (Ishikawa). J Clin Endocrinol Metab. 1997;82:136–42. doi: 10.1210/jc.82.1.136.PubMedCrossRefGoogle Scholar
  24. 24.
    Yoo HJ, Barlow DH, Mardon HJ. Temporal and spatial regulation of expression of hepatic-binding epidermal growth factor-like growth factor in the human endometrium: a possible role in blastocyst implantation. Dev Genet. 1997;21:102–8. doi: 10.1002/(SICI)1520-6408(1997)21:1<102::AID-DVG12>3.0.CO;2-C.PubMedCrossRefGoogle Scholar
  25. 25.
    Sher G, Herbert C, Maassarani G, Jacobs MH. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF-ET). Hum Reprod. 1991;6:232–7.PubMedGoogle Scholar
  26. 26.
    Baruffi RLR, Contart P, Mauri AL, Peterson C, Felipe V, Garbellini E, et al. A uterine ultrasonographic scoring system as a method for the prognosis of embryo implantation. J Assist Reprod Genet. 2002;19(3):99–102. doi: 10.1023/A:1014795502401.PubMedCrossRefGoogle Scholar
  27. 27.
    Papanikolaou EG, Kolibianakis EM, Tournaye H, Venetis CA, Fatemi H, Tarlatzis B, et al. Live birth rates after transfer of equal number of blastocysts or cleavage-stage embryos in IVF. A systematic review and meta-analysis. Hum Reprod. 2008;23(1):91–9. doi: 10.1093/humrep/dem339.PubMedCrossRefGoogle Scholar
  28. 28.
    Remohí J, Ardiles G, García-Velasco JA, Gaitán P, Simón C, Pellicer A. Endometrial thickness and serum oestradiol concentrations as predictors of outcome in oocyte donation. Hum Reprod. 1997;12(10):2271–6. doi: 10.1093/humrep/12.10.2271.PubMedCrossRefGoogle Scholar
  29. 29.
    Check JH, Nowroozi K, Choe J, Lurie D, Dietterich C. The effect of endometrial thickness and echo pattern on in vitro fertilization outcome in donor oocyte-embryo transfer cycle. Fertil Steril. 1993;59:72–5.PubMedGoogle Scholar
  30. 30.
    Abdalla HI, Brooks AA, Johnson MR, Kirkland A, Thomas A, Studd JW. Endometrial thickness: a predictor of implantation in ovum recipients? Hum Reprod. 1994;9:363–5.PubMedGoogle Scholar
  31. 31.
    Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril. 1999;71(1):147–9. doi: 10.1016/S0015-0282(98) 00413-0.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Matthew A. Barker
    • 1
    Email author
  • Lynn M. Boehnlein
    • 2
  • Peter Kovacs
    • 3
  • Steven R. Lindheim
    • 4
  1. 1.Department of Obstetrics and GynecologyGood Samaritan HospitalCincinnatiUSA
  2. 2.Department of Obstetrics and GynecologyUniversity of Wisconsin School of Medicine and Public HealthMadisonUSA
  3. 3.Kaali Institute, IVF CenterBudapestHungary
  4. 4.Fertility Specialists Medical GroupSan DiegoUSA

Personalised recommendations