Effect of triple line vs isoechogenic endometrial texture on pregnancy outcome following embryo transfer according to use of controlled ovarian stimulation (COH) or estrogen/progesterone replacement.

Purpose: To determine if pregnancy rates following embryo transfer are reduced if the endometrial echo pattern in the late proliferative phase is isoechogenic (IE) vs triple line (TL).

Methods: Pregnancy and implantation rates were compared according to TL vs IE pattern in the late proliferative phase in women having in vitro fertilization-embryo transfer (IVF-ET), frozen ET, and transfer of embryos derived from donor oocytes.

Results: There was no difference in pregnancy rates with IE vs TL pattern with fresh or frozen ET or in donor egg recipients.

Increasing the dosage of progesterone (P) supplemention from the mid-luteal phase in women not attaining a mid-luteal homogeneous hyperechogenic (HH) pattern with sonography improves pregnancy rates (PRS) following frozen embryo transfer (ET).

Purpose: To determine if a mid-luteal phase non-homogeneous hyperechogenic (HH) endometrial echo pattern may lower pregnancy rates following frozen embryo transfer and to determine if raising the dosage of progesterone improves pregnancy outcome.

Methods: Women not attaining an HH pattern at the mid-luteal phase following estrogen-progesterone replacement were randomly given (or not) an increase in progesterone dosage.

Results: Increasing the progesterone dosage in those not attaining an HH pattern significantly improved the pregnancy rate relative to controls not attaining an HH pattern and showed a trend for higher pregnancy rates than those with an HH pattern.

A method to improve false interpretation of the endometrial echo pattern as homogeneous hyperechogenic.

Endometrial echo patterns are generally evaluated and graded via transvaginal sonography; however, the uterine position can impede adequate visualization, giving the false impression of a hyperechogenic echo pattern before ovulation or oocyte retrieval. Transabdominal sonography can eliminate this error in the majority of cases when transvaginal ultrasound fails to provide diagnostic images of the endometrium.

Donor-recipient pairs to evaluate the effect of day 3 embryos having at least six blastomeres on pregnancy outcome.

Purpose: To determine if having all embryos transferred with at least six blastomeres improves pregnancy rates compared to women having an embryo transfer with at least one embryo with less than six cells.

Methods: Donor-recipient pairs were used to help remove the confounding effect of egg quality. Four donor-recipient pair types were evaluated: (1) both donor and recipient had all embryos with at least six cells, (2) neither donor nor recipient had all embryos with > or =6 cells, (3) donor but not recipient had all > or = six cell embryos, (4) recipient but not donor had all embryos with > or = six cells.

A comparison of luteal phase support in graduated estradiol/progesterone replacement cycles using intramuscular progesterone alone versus combination with vaginal suppositories on outcome following frozen embryo transfer.

Purpose: To compare pregnancy outcome following frozen embryo transfer according to type of progesterone (P) support given in the luteal phase.

Methods: Retrospective cohort analysis of frozen embryo transfer (ET) cycles in which ovulation was suppressed by graduated estradiol in the follicular phase. Two P regimens in the luteal phase were compared: P vaginal suppositories and intramuscular P vs intramuscular alone.