Role of Endometrial Thickness on Intracytoplasmic Sperm Injection

Problem statement: Endometrial receptivity is a key factor in successful outcome of in vitro fertilization. The endometrial receptivity is determined clinically by estimation of endometrial thickness and pattern by ultrasonography. This study was performed to evaluate the overall effect of endometrial thickness on pregnancy rate, multiple pregnancy rate and miscarriage rate in infertile women undergoing Intracytoplasmic Sperm Injection (ICSI) cycles at Mustasharak medical center, ABHA, Saudi Arabia. Approach: A prospective observational study at Mustasharak assisted reproduction center, ABHA, Saudi Arabia, was performed for women who underwent ICSI between Jan and Dec 2010. On the day of oocytes retrieval; after a true ultrasound longitudinal view of the uterus had been obtained, the endometrial thickness was measured as the maximum thickness between the highly reflective interfaces of the endometrial-myometrial junction. Results: 409 ICSI cycles were included in the study. The highest pregnancy rate was seen in patients who had an endometrial thickness of more than 12 mm, while those who had an endometrial thickness of less than 8 mm had the worst pregnancy rate. Type B endometrial morphology (trilaminar) had a significant higher pregnancy rate than type A endometrial morphology (non trilaminar). Conclusion: This study demonstrated a clear relationship between endometrial thickness on the day of oocytes collection and pregnancy rates following ICSI.