Endometrial sonographic parameters in prediction of intracytoplasmic sperm injection outcome following fresh embryo transfer in normal responders: a cohort study

ABSTRACT

Objective. To find the relation between the endometrial sonographic parameters and the success of ICSI in normal responders.
Material and Methods. A prospective cohort study was performed from September 2020 to March 2022 including 262 women normal responder women undergoing an ICSI cycle. Endometrial thickness (ET), endometrial pattern, and sub-endometrial blood flow were measured on the day of HCG. According to ET, the patients were classified into 3 groups: < 8 mm, 8-12 mm, and > 12 mm, according to endometrial pattern into a triple and non-triple line, as well as according to endo-sub endometrial blood flow into the zone I, zone II and zone III. Pregnancy rates were compared between all groups.
Results. The overall pregnancy rate among all groups was 43.12%. The clinical pregnancy rate was significantly lower with ET below 7 mm, but increased in the group with ET 8-12 mm 86/113 (76.1%), lower in the group with ET > 12 mm 25/113 (22.1%), and lowest when ET < 8 mm 2/113 (1.8%). The pregnancy rate in the triple endometrial pattern 70/113 (61.9%) is higher than in the non-triple pattern 43/113 (38.1%). However, the endo-sub endometrial blood flow did not affect the pregnancy rate significantly (P-value = 0.435).
Conclusions. Endometrial thickness exhibits a curvilinear relationship with pregnancy outcomes in fresh embryo transfer cycles. A triple ET 8 mm thickness or more, could be a reliable predictor for successful pregnancy outcomes in fresh ICSI cycles. Yet, ET (≤ 7 mm) and no triple-line endometrial pattern coexist in an ICSI candidate, cryopreservation should be recommended.