Publication:

Relation of endometrial thickness and pregnancy rates in intrauterine insemination following ovulation induction

Background Controlled ovarian hyper stimulation (COH) using different agents with intrauterine insemination (IUI) are known treatment for infertility. Endometrial thickness (ET) is one of the predicting factors for clinical pregnancy along with other parameters. Many studies have been done in the past to find factors affecting the growth and maturity of the endometrium in women in IUI, but indigenous Indian studies regarding its relation with pregnancy were either limited or the results were unclear.

Methods A Prospective observational study was undertaken for assessing effects of clomiphene citrate (CC) and human menopausal gonadotropin (hMG) stimulated cycles on the ET and clinical pregnancy in single IUI cycle. Infertility cases were studied in two groups; Group A [ovulation induction (OI) with CC and IUI; n=101] and Group B (OI with hMG and IUI; n=103) after randomization using random number table as per standard protocol.

Results Comparable data obtained in mean age, duration of infertility, female and male factors in both groups. Mean ET on day of IUI in Group A and B was 8.35+2.08mm and 10.87+2.54mm respectively (p value <0.001). Range of ET in clinical pregnancies in Group A (n= 15) were 8.0- 12.9mm and 9.0- 12.9mm in Group B (n= 26). Ongoing pregnancies beyond 1st trimester were higher in Group B (n= 25) than Group A (n= 14).

Conclusions Mean ET and clinical pregnancy rate both were higher in hMG group compared to CC. This study identified an ‘optimum endometrial thickness’ (9.0-12.9mm) for achieving clinical pregnancy in hMG group.