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Background: To evaluate the relationship between endometrial thickness on day of human chorionic gonadotrophin administration (hCG) and pregnancy outcome in a large number of consecutive in vitro fertilization and embryo transfer (IVF-ET) cycles. Methods: A retrospective cohort study including all patients who had IVF-ET from January 2003- December 2005 conducted at a tertiary center. Results: A total of 2464 cycles were analysed. Pregnancy rate (PR) was 35.8%. PR increased linearly (r = 0.864) from 29.4% among patients with a lining of less than or equal to 6 mm, to 44.4% among patients with a lining of greater than or equal to 17 mm. ROC showed that endometrial thickness is not a good predictor of PR, so a definite cut-off value could not be established (AUC = 0.55). Conclusion: There is a positive linear relationship between the endometrial thickness measured on the day of hCG injection and PR, and is independent of other variables. Hence aiming for a thicker endometrium should be considered.
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Reproductive Biology and
BioMed Central
Endocrinology
Open Access
Research
The correlation between endometrial thickness and outcome of in
vitro fertilization and embryo transfer (IVF-ET) outcome
Ahlam Al-Ghamdi*, Serdar Coskun, Saad Al-Hassan, Rafat Al-Rejjal and
Khalid Awartani
Address: Reproductive Medicine, Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre Riyadh, Kingdom
of Saudi Arabia
Email: Ahlam Al-Ghamdi* - ahlamaag@yahoo.com; Serdar Coskun - serdar@kfshrc.edu.sa; Saad Al-Hassan - Hassan@kfshrc.edu.sa; Rafat Al-
Rejjal - rejjal@kfshrc.edu.sa; Khalid Awartani - kawartani@kfshrc.edu.sa
* Corresponding author
Published: 2 September 2008
Received: 22 May 2008
Accepted: 2 September 2008
Reproductive Biology and Endocrinology 2008, 6:37
doi:10.1186/1477-7827-6-37
This article is available from: http://www.rbej.com/content/6/1/37
© 2008 Al-Ghamdi et al; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: To evaluate the relationship between endometrial thickness on day of human
chorionic gonadotrophin administration (hCG) and pregnancy outcome in a large number of
consecutive in vitro fertilization and embryo transfer (IVF-ET) cycles.
Methods: A retrospective cohort study including all patients who had IVF-ET from January 2003–
December 2005 conducted at a tertiary center.
Results: A total of 2464 cycles were analysed. Pregnancy rate (PR) was 35.8%. PR increased
linearly (r = 0.864) from 29.4% among patients with a lining of less than or equal to 6 mm, to 44.4%
among patients with a lining of greater than or equal to 17 mm. ROC showed that endometrial
thickness is not a good predictor of PR, so a definite cut-off value could not be established (AUC
= 0.55).
Conclusion: There is a positive linear relationship between the endometrial thickness measured
on the day of hCG injection and PR, and is independent of other variables. Hence aiming for a
thicker endometrium should be considered.
Background
vaginal ultrasound, which is considered as both
Assisted reproductive technology (ART) has been com-
atraumatic and simple [1]. The effect of endometrial
monly used in infertility treatment over the last two dec-
thickness on pregnancy rates in ART patients has been
ades. The high cost and relatively low implantation and
evaluated by many authors [2-11], with controversial
pregnancy rates (PRs) in in-vitro fertilization (IVF) and
results. Some authors demonstrated a higher pregnancy
intracytoplasmic sperm injection (ICSI) treatment cycles
rate at certain endometrial thickness [3,4,10-12], while
has led to a need to evaluate the predictors of success in
others did not show a significant correlation between
these patients. One of the important factors is the
endometrial thickness and PRs in IVF/ICSI patients
endometrial receptivity. Endometrial thickness has been
[5,7,8]. Other authors reported a threshold of <7 mm
utilized as an indirect indicator for endometrial receptiv-
and/or >14 mm with a significant reduction in implanta-
ity and is measured in the midsaggital plane during trans-
tion rate and PR [2,6].
Page 1 of 5
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Reproductive Biology and Endocrinology 2008, 6:37
http://www.rbej.com/content/6/1/37
With these controversies, no conclusive cut-off value of
of oocyte retrieved, length of stimulation, dose of hMG,
endometrial thickness has been established in order to
fertilization rate, number of cleaved embryos, number of
help clinicians in counseling the couple about the out-
transferred embryos.
come. The reason for such controversy could be probably
due to a relatively low number of cycles for patients with
Statistical analysis
both extremes of endometrial thicknessess.
Data were analyzed using SPSS version 14 software (Chi-
cago, Ilin, USA). All tests were two tailed, and p < 0.05 was
The aim of this study is to determine if there is any effect
considered statistically significant. Continuous variables
of endometrial thickness measured on the day of admin-
are presented as mean and SD and were tested by student's
istration of human Chorionic Gonadotrphin (hCG) on
t-test. Comparisons of proportions were made by the chi-
pregnancy rate while analyzing large number of cycles,
squared test. The effect of endometrial thickness on the
and if so, to identify a cut off value at which pregnancy
pregnancy outcome was studied using multivariate analy-
rate is too low, hence helping clinicians in counceling the
sis, where all other factors affecting the pregnancy out-
couples.
come were controlled for. To determine the correlation
between endometrial thickness, patient characteristics
Methods
and treatment characteristics a stepwise logistic regression
All fresh cycles of IVF or ICSI conducted at King Faisal Spe-
analysis was performed including (age of the patient,
cialist Hospital and Research Center IVF unit from January
body mass index (BMI), endometrial thickness on day 3
2003 to December 2005 were identified from our elec-
of the cycle, duration of stimulation, dose of hMG
tronic database and the charts were reviewed. The study
needed, number of oocytes retrieved, number of cleaved
was approved by the Ethics Committee of our hospital. All
embryos, and number of embryos transferred). The
fresh IVF or ICSI treatment cycles that reached oocyte pick
Receiver operating characteristic (ROC) analysis was used
up and embryo transfer within the study period were
to evaluate an endometrial thickness that can predict preg-
included, women with known intrauterine anomalies
nancy outcome.
were excluded from the study. Endometrial thickness was
not used as a criteria for cancellation. Endometrial thick-
Results
ness was defined as the maximal distance between the
A total of 2464 cycles were included in the study. Clinical
echogenic interfaces of the myometrium and the
pregnancy rate (PR) was 35.8%. 79% of the patients had
endometrium and was measured in the midsagittal plane
undergone the long protocol. The pregnancy rate was
by two dimensional transvaginal ultrasound on the day of
39.4% in the long protocol group vs 22.4% in the short
hCG administration.
protocol group. Compared to group B, group A patients
were younger, required lower dose of hMG, had more
Two protocols for pituitary down regulation were used,
medium sized and mature follicles, higher number of
long or short protocol as previously described [1]. The
oocytes retrieved, higher number of oocytes fertilized, and
medication for stimulation used in all cases was human
higher number of cleaved embryos. Both groups had sim-
menopausal gonadotrophin (hMG, Menegon®, Ferring,
ilar BMI, duration of stimulation, baseline endometrial
Germany). When at least three follicles were ≥ 18 mm,
thickness (measured on day 3 of the cycle before the start
hCG 10,000 units was administered. The endometrial
of hMG), and number of transferred embryos (Table 1).
thickness was measured by the same sonographer and
There was no statistical difference between the two groups
documented in the chart. Oocyte retrieval was performed
in the primary infertility diagnosis (Table 2). Endometrial
36 hours later. Fertilization was achieved by IVF or ICSI
thickness measured on the day of hCG administration
according to the indication. Cleavage stage embryos were
ranged between 5 – 20 mm, and was higher in cycles
transferred on day 3. Maximum two embryos were trans-
where pregnancy was achieved, with statistical signifi-
ferred under transabdominal ultrasound guidance with a
cance (mean 11.6 vs. 11.3 mm, respectively, p < 0.0001).
full bladder. The patients were started on IM progesterone
Pregnancy rate increased from 29.4% among patients
injections (Gestone, Nordic Pharma, UK) on the same day
with an endometrial thickness of ≤6 mm, to 44.4%
of embryo transfer for luteal phase support and continued
among patients with an endometrial thickness of ≥17 mm
till pregnancy test on day 15. Clinical pregnancy was con-
(Table 3). (Figure 1) shows the positive linear correlation
firmed by ultrasound observation of fetal cardiac activity
(r = 0.864) and ROC with an area under the curve (AUC)
two weeks after positive hCG test.
= 0.55. From this ROC a cut-off value of ≥11 mm would
be suggested. When dividing the patients into two groups,
The patients were divided into two groups; those who got
group 1 with endometrial thickness of <11 mm, and
pregnant (group A) and those who did not (group B).
group 2 with endometrial thickness ≥11 mm, PRs were
Both groups were compared for the various parameters
30.9% and 38.7% respectively, p = 0.001, RR = 1.25
including age, body mass index (BMI), diagnosis, number
(95%CI 1.12–1.41) (Table 4). Multiple logistic regression
Page 2 of 5
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Reproductive Biology and Endocrinology 2008, 6:37
http://www.rbej.com/content/6/1/37
Table 1: Demographic data
Characteristics
Group A
Group B
P value
mean ± SD
mean ± SD
Number of cycles (n)
882
1582
Age (years)
30.27 ± 5.53
31.14 ± 5.38
0.0001
BMI (weight kg/height m2)
28.44 ± 4.58
28.32 ± 4.42
0.524
Long protocol # (%)
765 (39.4%)
1177 (60.6%)
< 0.0001
Short protocol # (%)
117 (22.4%)
405 (77.6%)
Stimulation length (days)
10.92 ± 2.63
10.79 ± 2.46
0.228
Dose of hMG (ampoules)
37.67 ± 15.03
40.73 ± 16.54
< .0001
Endometrial thickness cycle day 3 (mm)
3.23 ± 1.22
3.21 ± 1.22
0.696
Endometrial thickness hCG day (mm)
11.64 ± 2.13
11.26 ± 2.17
< 0.0001
Number of medium sized follicles
8.08 ± 5.33
7.12 ± 5.31
< 0.0001
Number of mature follicles
7.92 ± 3.51
7.62 ± 3.69
0.0475
Number of oocytes retrieved
10.51 ± 5.43
9.86 ± 5.73
0.006
Number of fertilized oocytes
5.79 ± 3.23
4.97 ± 3.35
< 0.0001
Number of embryos
5.3 ± 2.82
4.44 ± 2.81
< 0.0001
Number of embryos transferred
1.88 ± 0.37
1.98 ± 0.26
0.001
analysis indicated significant independent effects of age (P
line and that on hCG day [15]. Our results are with agree-
= 0.01), Type of protocol used (P = 0.0001), endometrial
ment to those that reported a positive correlation [3,4,10-
thickness on hCG day (P = 0.001), number of oocytes
21]. Endometrial thickness measured on the day of hCG
retrieved (P = 0.0001), number of cleaved embryos (P =
administration was higher in cycles where pregnancy was
0.0001), and number of embryos transferred (P = 0.0001)
achieved (mean 11.6 vs. 11.3 mm, respectively, p <
on pregnancy rates.
0.0001), but the difference is not of clinical significance,
because results fell within the range of measurement
Discussion
error. When using a multiple logistic regression analysis to
This study is to our knowledge so far the largest in regards
control all other confounding variables, we found an
to sample size that addresses the effect of endometrial
independent effect of endometrial thickness on PR. The
thickness on PR. The day of the stimulation cycle on
uniqueness of this study is that it demonstrated a steady
which the endometrial thickness is measured to docu-
and gradual increase in PR as endometrial thickness
ment adequate endometrial development has varied
increases. Many previous studies reported significant dif-
between authors. The most often used is the measurement
ferences in PRs above and below a threshold thickness of
taken on the day of hCG administration, but some
8 – 10 mm, but didn't show a continuous relationship
authors have used the measurement that was taken on the
such as we found [3,4,11,12,19]. Although we found a
day of oocyte retrieval or the day of embryo transfer in
clear positive correlation between endometrial thickness
their studies, which makes it difficult to compare between
and PR, our PR was 29.4% among patients with ≤ 6 mm
studies. We have used the measurement taken on the day
endometrial thickness in contrast to Gonen et al 1990
of hCG administration in our data. The change in
who reported poor PR with endometrial thickness < 6 mm
endometrial thickness occurring during IVF stimulation
[14]. Furthermore, there were several reports of successful
has been evaluated by several authors [8,13,14]. Grant et
pregnancies resulting from cycles with endometrial thick-
al 2007, demonstrated a trend toward significance in the
ness of ≤ 4 mm [22] indicating that a thin endometrium
overall change in endometrial thickness between the base-
does not necessarily preclude the possibility of implanta-
tion. Hence cancellation of cycle based on a thin
Table 2: Diagnostic categories
endometrium is unwarranted.
Diagnosis
Group A
Group B
(882)
(1582)
Some authors suggested a detrimental effect of endome-
trial thickness of ≥ 14 mm on PR [6]. Our results on the
Male factor 1763 (71.6%)
623 (70.6%)
1140 (72.0%)
contrary, suggest that PRs are highest for patients with the
Tubal factor 338 (13.7%)
114 (13.0%)
224 (14.2%)
thickest lining, and are consistent with other recent stud-
Unexplained 213 (8.6%)
85 (9.6%)
128 (8.1%)
ies finding no reduction in PRs with very thick
Others 150 (6.1%)
60 (6.8%)
90 (5.7%)
endometrium [16,23-25]. In fact there was a case report of
a successful twin pregnancy after IVF with an endometrial
P = 0.319
Page 3 of 5
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Reproductive Biology and Endocrinology 2008, 6:37
http://www.rbej.com/content/6/1/37
Table 3: Pregnancy rates at different endometrial thicknesses
Endometrial thickness on day of HCG
Group A (n)
Group B (n)
Pregnancy rate
≤6 mm
5
12
29.40%
7 mm
11
34
24.40%
8 mm
35
96
26.70%
9 mm
70
171
29.00%
10 mm
162
321
33.50%
11 mm
140
240
36.80%
12 mm
174
275
38.80%
13 mm
130
202
39.20%
14 mm
82
122
40.20%
15 mm
38
62
38.00%
16 mm
19
27
41.30%
≥17 mm
16
20
44%
Total
882
1582
35.80%
Table 4: Pregnancy rates below and above 11 mm endometrial thickness
Endometrial thickness on day of HCG
Group A (n)
Group B (n)
Pregnancy rate
< 11 mm
283
634
30.90%
≥ 11 mm
599
948
38.70%
Total
882
1582
35.80%
P = 0.001
RR = 1.25, (95% CI 1.12–1.41)
ROC Curve
1.00
45.00
40.00
.75
35.00
t
n
e
.50
c
r
pe
30.00
.25
25.00
R Sq Linear = 0.864
20.00
Sensitivity 0.00
0.00
.25
.50
.75
1.00
1 - Specificity
Diagonal segments are produced by ties.
The ROC and linear
Figure 1
regression curves
The ROC and linear regression curves.
Page 4 of 5
(page number not for citation purposes)
endohcg2
7.50
10.00
12.50
15.00
17.50

Reproductive Biology and Endocrinology 2008, 6:37
http://www.rbej.com/content/6/1/37
thickness of 20 mm [26]. Limitations of our study, it is ret-
7.
De Geyter C, Schmitter M, De Geyter M, Nieschlag E, Holzgreve W,
rospective in nature, but all patients received hMG for
Schneider HP: Prospective evaluation of the ultrasound
appearance of the endometrium in a cohort of 1,186 infertile

stimulation, hence eliminating the bias that can result
women. Fertil Steril 2000, 73:106-113.
from different stimulation medications and their different
8.
Bassil S: Changes in endometrial thickness, thickness, length
and pattern in predicting pregnancy outcome during ovarian

effects on endometrial proliferation. Similarily the
stimulation in in vitro fertilization. Ultrasound Obstet Gynecol
number of embryos transferred was limited to two, unless
2001, 18:258-263.
there was only one embryo available for transfer, to con-
9.
Schild RL, Knobloch C, Dorn C, Fimmers R, Ven H van der, Hans-
mann M: Endometrial receptivity in an in vitro fertilization
trol its effect on PR. The poor predictive value of the ROC
program as assessed by spiral artery blood flow, endometrial
analysis makes it difficult to accurately determine a cut-off
thickness, endometrial volume, and uterine artery blood
value, never the less, adequate endometrial development
flow. Fertil Steril 2001, 75:361-366.
10.
Kovacs P, Matyas S, Boda K, Kaali SG: The effect of endometrial
is required for pregnancy to occur, and PR were found to
thickness on IVF/ICSI outcome. Hum Reprod 2003,
be higher when the endometrium reached at least 11 mm
18:2337-2341.
11.
Check JH, Nowroozi K, Choe J, Dietterich C: Influence of
thickness.
endometrial thickness and echo patterns on pregnancy rates
during in vitro fertilization.
Fertil Steril 1991, 56:1173-1175.
Conclusion
12.
Dickey RP, Olar TT, Curole DN, Taylor SN, Rye PH: Endometrial
pattern and thickness associated with pregnancy outcome

The results of the present study identified a positive linear
after assisted reproduction technologies. Hum Reprod 1992,
correlation between endometrial thickness measured on
7:418-421.
13.
Gonen Y, Casper RF, Jacobson W, Blankier J: Endometrial thick-
hCG day and PR. Therefore, clinicians must pay close
ness and growth during ovarian stimulation: a possible pre-
attention to endometrial development as well as to folli-
dictor of implantation in in vitro fertilization. Fertil Steril 1989,
cle growth. But again cancellation of embryo transfer
52:446-450.
14.
Gonen Y, Casper RF: Prediction of implantation by the sono-
based on a thin endometrial lining is unwarranted.
graphic appearance of the endometrium during controlled
ovarian stimulation for in vitro fertilization (IVF).
J In Vitro Fert
Competing interests
Embryo Transfer 1990, 7:146-152.
15.
McWilliams Grant DE, Frattarelli John L: Changes in measured
The authors declare that they have no competing interests.
endometrial thickness predict in vitro fertilization success.
Fertil Steril 2007, 88:74-81.
16.
Sher G, Herbert C, Maassarani G, Jacobs MH: Assessment of the
Authors' contributions
late proliferative phase endometrium by ultrasonography in
All authors made substantial contribution to conception
patients undergoing in-vitro fertilization and embryo trans-
and design of the research. AA acquired the data and wrote
fer (IVF/ET). Hum Reprod 1991, 6:232-237.
17.
Glissant A, de Mouzon J, Frydman R: Ultrasound study of the
the manuscript. KA performed the statistical analysis and
endometrium during in vitro fertilization cycles. Fertil Steril
interpreted the data, and SC critically revised the manu-
1985, 44:786-790.
script. Again all authors gave the final approval of the
18.
Zhang Xingpi, Chen Chi-Huang, Confino Edmond, Barnes Randall,
Milad Magdy, Kazer Ralph R: Increased endometrial thickness is
manuscript.
associated with improved treatment outcome for selected
patients undergoing in vitro fertilization – embryo transfer.
Fertil Steril 2005, 83:336-340.
Acknowledgements
19.
Check JH, Nowroozi K, Choe J, Lurie D, Dietterich C: The effect of
We would like to thank Dr Mohamed Gamal El Din Hassan (PhD) Scientist/
endometrial thickness and echo pattern on in-vitro fertiliza-
Biostatistician from Biostatistics, Epidemiology and Scientific Computing
tion outcome in donor oocyte-embryo transfer cycle. Fertil
Steril
1993, 59:72-75.
(BESC), Research Center KFSHRC) for his help in the statistical analysis.
20.
Wiser Amir, Baum Micha, Hourwitz Ariel, Lerner-Geva Liat, Dor
Jehoshua, Shulman Adrian: Predicting factors for endometrial
References
thickness during treatment with assisted reproductive tech-
1.
Freidler S, Schenker JG, Herman A, Lewin A: The role of ultra-
nology. Fertil Steril 2007, 87:799-804.
sonography in the endometrial receptivity following assisted
21.
Richter Kevin S, Bugge Kathleen R, Bromer Jason G, Levy Michael J:
reproduction treatmens: a critical review. Hum Reprod Update
Relationship between endometrial thickness and embryo
1996, 2:323-335.
implantation, based on 1,294 cycles of in vitro fertilization
2.
Isaacs JD Jr, Wells CS, Williams DB, Odem RR, Gast MJ, Strickler RC:
with transfer of two blastocyst-stage embryos. Fertil Steril
Endometrial thickness is a valid monitoring parameter in
2007, 87:53-59.
cycles of ovulation induction with menotropins alone. Fertil
22.
Sundstrom P: Establishment of a successful pregnancy follow-
Steril 1996, 65:262-266.
ing in vitro fertilization with an endometrial thickness of no
3.
Noyes N, Liu HC, Sultan K, Schattman G, Rosenwaks Z: Endome-
more than 4 mm. Hum Reprod 1998, 13:1550-1552.
trial thickness appears to be a significant factor in embryo
23.
Yakin K, Akarsa C, Kahraman S: Cycle lumping or sampling – a
implantation in in-vitro fertilization. Hum Reprod 1995,
witches' brew? Fertil Steril 2000, 73:175.
10:919-922.
24.
Dietterich C, Check JH, Choe JK, Nazari A, Lurie D: Increased
4.
Rinaldi L, Lisi F, Floccari A, Lisi R, Pepe G, Fishel S: Endometrial
endometrial thickness on the day of human chorionic gona-
thickness as a predictor of pregnancy after in-vitro fertiliza-
dotropin (hCG) injection does not adversely effect preg-
tion but not after intracytoplasmic sperm injection. Hum
nancy or implantation rates following in vitro fertilization-
Reprod 1996, 11:1538-1541.
embryo transfer (IVF-ET). Fertil Steril 2002, 77:781-786.
5.
Yuval Y, Lipitz S, Dor J, Achiron R: The relationships between
25.
Yoeli R, Ashkenazi J, Orvieto R, Shelef M, Kaplan B, Bar-Hava I: Sig-
endometrial thickness, and blood flow and pregnancy rates
nificance of increased endometrial thickness in assisted
in in-vitro fertilization. Hum Reprod 1999, 14:1067-1071.
reproduction technology treatments. J Assist Reprod Genet
6.
Weissman A, Gotlieb L, Casper RF: The detrimental effect of
2004, 21:285-289.
increased endometrial thickness on implantation and preg-
26.
Quintero RB, Sharara FI, Milki AA: Successful pregnancies in the
nancy rates and outcome in an in vitro fertilization program.
setting of exaggerated endometrial thickness. Fertil Steril 2004,
Fertil Steril 1999, 71:147-149.
82:215-217.
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