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Geburtshilfe Frauenheilkd 2012; 72(8): 710-715
DOI: 10.1055/s-0032-1315059
Review
GebFra Science
Georg Thieme Verlag KG Stuttgart · New York

Endometrial Receptivity and its Predictive Value for IVF/ICSI-Outcome

Die endometriale Rezeptivität in der IVF-Therapie
A. Heger
1   Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
,
M. Sator
1   Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
2   Fertility Center Doebling, Ambulatorium Doebling, Vienna, Austria
,
D. Pietrowski
1   Obstetrics and Gynecology, Medical University of Vienna, Vienna, Austria
2   Fertility Center Doebling, Ambulatorium Doebling, Vienna, Austria
› Author Affiliations
Further Information

Publication History

received 29 March 2012
revised 12 June 2012

accepted 26 June 2012

Publication Date:
28 August 2012 (online)

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Abstract

Endometrial receptivity plays a crucial role in the establishment of a healthy pregnancy in cycles of assisted reproduction. The endometrium as a key factor during reproduction can be assessed in multiple ways, most commonly through transvaginal grey-scale or 3-D ultrasound. It has been shown that controlled ovarian hyperstimulation has a great impact on the uterine lining, which leads to different study results for the predictive value of endometrial factors measured on different cycle days. There is no clear consensus on whether endometrial factors are appropriate to predict treatment outcome and if so, which one is suited best. The aim of this review is to summarize recent findings of studies about the influence of endometrial thickness, volume and pattern on IVF- and ICSI-treatment outcome and provide an overview of future developments in the field.

Zusammenfassung

Die endometriale Rezeptivität spielt eine entscheidende Rolle für den Beginn und den Erhalt einer Schwangerschaft. Die physiologische Ausbildung eines implantationsfördernden und -erhaltenden Endometriums wird daher als Schlüsselfaktor bei allen fertilitätsunterstützenden therapeutischen Behandlungen angesehen. Dabei wird in der Praxis der Zustand des Endometriums mithilfe des Einsatzes des transvaginalen Ultraschalls bestimmt. Die kontrollierte ovarielle Überstimulation, wie sie im Rahmen einer IVF-Therapie angewandt wird, kann einen erheblichen Einfluss auf den Zustand des Endometriums zum Zeitpunkt der Untersuchung haben. Bislang gibt es allerdings keinen klaren Konsens darüber, ob endometriale Faktoren geeignet sind, um das Behandlungsergebnis einer IVF-Therapie verlässlich vorhersagen zu können. Das Ziel dieser Übersichtsarbeit ist es daher, die aktuellen wissenschaftlichen Ergebnisse über den Einfluss der mithilfe von Ultraschallmessungen gewonnenen endometrialen Parametern im Rahmen der IVF-Behandlung zusammenzufassen und einen Überblick über zukünftige Entwicklungen auf diesem Gebiet zu geben.

Key words

assisted reproductive technology (ART) - pregnancy - sonography

Schlüsselwörter

assistierte Reproduktion - Schwangerschaft - Ultraschall
 

  • References

  • 1 Bourgain C, Devroey P. The endometrium in stimulated cycles for IVF. Hum Reprod Update 2003; 9: 515-522
    CrossrefPubMedGoogle Scholar
  • 2 Makker A, Singh MM. Endometrial receptivity: clinical assessment in relation to fertility, infertility, and antifertility. Med Res Rev 2006; 26: 699-746
    CrossrefPubMedGoogle Scholar
  • 3 Senturk LM, Erel CT. Thin endometrium in assisted reproductive technology. Curr Opin Obstet Gynecol 2008; 20: 221-228
    CrossrefPubMedGoogle Scholar
  • 4 Rogenhofer N, Bohlmann MK, Thaler CJ et al. Habituelle Abortneigung: Evidenzbasierte Diagnostik und Therapie. Geburtsh Frauenheilk 2010; 70: 544-552
    Article in Thieme ConnectPubMedGoogle Scholar
  • 5 Beier HM, Beier-Hellwig K. Molecular and cellular aspects of endometrial receptivity. Hum Reprod Update 1998; 4: 448-458
    CrossrefPubMedGoogle Scholar
  • 6 Cittadini E, Palermo R. The endometrium in human assisted reproduction. Ann N Y Acad Sci 1991; 622: 230-235
    CrossrefPubMedGoogle Scholar
  • 7 Sterzik K, Grab D, Rosenbusch B et al. [Receptivity of the endometrium: comparison of ultrasound and histologic findings after hormonal stimulation]. Geburtsh Frauenheilk 1991; 51: 554-558
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Cohen J. A short review of ovarian stimulation in assisted reproductive techniques. Reprod Biomed Online 2003; 6: 361-366
    CrossrefPubMedGoogle Scholar
  • 9 Manno M, Cervi M, Zadro D et al. Different ART outcomes at increasing peak estradiol levels with long and antagonist protocols: retrospective insights from ten years experience. J Assist Reprod Genet 2011; 28: 693-698
    CrossrefPubMedGoogle Scholar
  • 10 Ye H, Huang GN, Zeng PH et al. IVF/ICSI outcomes between cycles with luteal estradiol (E2) pre-treatment before GnRH antagonist protocol and standard long GnRH agonist protocol: a prospective and randomized study. J Assist Reprod Genet 2009; 26: 105-111
    CrossrefPubMedGoogle Scholar
  • 11 Al-Ghamdi A, Coskun S, Al-Hassan S et al. The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reprod Biol Endocrinol 2008; 6: 37
    CrossrefPubMedGoogle Scholar
  • 12 Okohue JE, Onuh SO, Ebeigbe P et al. The effect of endometrial thickness on in vitro fertilization (IVF) – embryo transfer/intracytoplasmic sperm injection (ICSI) outcome. Afr J Reprod Health 2009; 13: 113-121
    PubMedGoogle Scholar
  • 13 Chen SL, Wu FR, Luo C et al. Combined analysis of endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer: a retrospective cohort study. Reprod Biol Endocrinol 2010; 8: 30
    CrossrefPubMedGoogle Scholar
  • 14 Kinay T, Tasci Y, Dilbaz S et al. The relationship between endometrial thickness and pregnancy rates in GnRH antagonist down-regulated ICSI cycles. Gynecol Endocrinol 2010; 26: 833-837
    CrossrefPubMedGoogle Scholar
  • 15 Merce LT, Barco MJ, Bau S et al. Are endometrial parameters by three-dimensional ultrasound and power Doppler angiography related to in vitro fertilization/embryo transfer outcome?. Fertil Steril 2008; 89: 111-117
    CrossrefPubMedGoogle Scholar
  • 16 Richter KS, Bugge KR, Bromer JG et al. Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril 2007; 87: 53-59
    CrossrefPubMedGoogle Scholar
  • 17 Traub ML, Van Arsdale A, Pal L et al. Endometrial thickness, Caucasian ethnicity, and age predict clinical pregnancy following fresh blastocyst embryo transfer: a retrospective cohort. Reprod Biol Endocrinol 2009; 7: 33
    CrossrefPubMedGoogle Scholar
  • 18 Müller A, Bals-Pratsch M, Oppelt PG et al. Kultur von mehr als 3 2-PN-Stadien in der täglichen Praxis – eine Pilotstudie in Kongruenz mit dem Embryonenschutzgesetz. Geburtsh Frauenheilk 2011; 71: 779-783
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Gonen Y, Casper RF. Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF). J In Vitro Fert Embryo Transf 1990; 7: 146-152
    CrossrefPubMedGoogle Scholar
  • 20 Welker BG, Gembruch U, Diedrich K et al. Transvaginal sonography of the endometrium during ovum pickup in stimulated cycles for in vitro fertilization. J Ultrasound Med 1989; 8: 549-553
    PubMedGoogle Scholar
  • 21 Eden JA, Place J, Carter GD et al. The effect of clomiphene citrate on follicular phase increase in endometrial thickness and uterine volume. Obstet Gynecol 1989; 73: 187-190
    PubMedGoogle Scholar
  • 22 Fleischer AC, Pittaway DE, Beard LA et al. Sonographic depiction of endometrial changes occurring with ovulation induction. J Ultrasound Med 1984; 3: 341-346
    PubMedGoogle Scholar
  • 23 Yagel S, Ben-Chetrit A, Anteby E et al. The effect of ethinyl estradiol on endometrial thickness and uterine volume during ovulation induction by clomiphene citrate. Fertil Steril 1992; 57: 33-36
    PubMedGoogle Scholar
  • 24 Csemiczky G, Wramsby H, Johannisson E et al. Endometrial evaluation is not predictive for in vitro fertilization treatment. J Assist Reprod Genet 1999; 16: 113-116
    CrossrefPubMedGoogle Scholar
  • 25 Valbuena D, Jasper M, Remohi J et al. Ovarian stimulation and endometrial receptivity. Hum Reprod 1999; 14 (Suppl. 02) 107-111
    CrossrefPubMedGoogle Scholar
  • 26 Macklon NS, Fauser BC. Impact of ovarian hyperstimulation on the luteal phase. J Reprod Fertil Suppl 2000; 55: 101-108
    PubMedGoogle Scholar
  • 27 Van Der Gaast MH, Beckers NG, Beier-Hellwig K et al. Ovarian stimulation for IVF and endometrial receptivity – the missing link. Reprod Biomed Online 2002; 5 (Suppl. 01) 36-43
    PubMedGoogle Scholar
  • 28 Dockery P, Rogers AW. The effects of steroids on the fine structure of the endometrium. Baillieres Clin Obstet Gynaecol 1989; 3: 227-248
    CrossrefPubMedGoogle Scholar
  • 29 Kolb BA, Paulson RJ. The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of this hyperstimulation on embryo implantation. Am J Obstet Gynecol 1997; 176: 1262-1267 discussion 1267–1269
    CrossrefPubMedGoogle Scholar
  • 30 Sharara FI, McClamrock HD. High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril 1999; 72: 401-405
    CrossrefPubMedGoogle Scholar
  • 31 Pöhls UG, Meurer B, Schälicke M et al. 3D Sonographie in der Gynäkologie. Geburtsh Frauenheilk 2005; 65: R85-R104
    Article in Thieme ConnectPubMedGoogle Scholar
  • 32 Dickey RP, Olar TT, Curole DN et al. Endometrial pattern and thickness associated with pregnancy outcome after assisted reproduction technologies. Hum Reprod 1992; 7: 418-421
    PubMedGoogle Scholar
  • 33 Amir W, Micha B, Ariel H et al. Predicting factors for endometrial thickness during treatment with assisted reproductive technology. Fertil Steril 2007; 87: 799-804
    CrossrefPubMedGoogle Scholar
  • 34 Sakamoto C, Yoshimitsu K, Nakamura G et al. Sonographic study of the endometrial responses to ovarian hormones in patients receiving ovarian stimulation. Int J Gynaecol Obstet 1988; 27: 407-414
    CrossrefPubMedGoogle Scholar
  • 35 Kehila M, Kebaili S, Bougmiza I et al. [Endometrial thickness in in vitro fertilization. A study of 414 cases]. Tunis Med 2010; 88: 928-932
    PubMedGoogle Scholar
  • 36 Bozdag G, Esinler I, Yarali H. The impact of endometrial thickness and texture on intracytoplasmic sperm injection outcome. J Reprod Med 2009; 54: 303-311
    PubMedGoogle Scholar
  • 37 Corbacioglu A, Baysal B. Effects of endometrial thickness and echogenic pattern on assisted reproductive treatment outcome. Clin Exp Obstet Gynecol 2009; 36: 145-147
    PubMedGoogle Scholar
  • 38 Laasch C, Puscheck E. Cumulative embryo score, not endometrial thickness, is best for pregnancy prediction in IVF. J Assist Reprod Genet 2004; 21: 47-50
    CrossrefPubMedGoogle Scholar
  • 39 Yoeli R, Ashkenazi J, Orvieto R et al. Significance of increased endometrial thickness in assisted reproduction technology treatments. J Assist Reprod Genet 2004; 21: 285-289
    CrossrefPubMedGoogle Scholar
  • 40 Rashidi BH, Sadeghi M, Jafarabadi M et al. Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern. Eur J Obstet Gynecol Reprod Biol 2005; 120: 179-184
    CrossrefPubMedGoogle Scholar
  • 41 Coulam CB, Bustillo M, Soenksen DM et al. Ultrasonographic predictors of implantation after assisted reproduction. Fertil Steril 1994; 62: 1004-1010
    PubMedGoogle Scholar
  • 42 Sharara FI, Lim J, McClamrock HD. Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration. J Assist Reprod Genet 1999; 16: 523-528
    CrossrefPubMedGoogle Scholar
  • 43 Lesny P, Killick SR, Tetlow RL et al. Ultrasound evaluation of the uterine zonal anatomy during in-vitro fertilization and embryo transfer. Hum Reprod 1999; 14: 1593-1598
    CrossrefPubMedGoogle Scholar
  • 44 Zhang X, Chen CH, Confino E et al. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril 2005; 83: 336-340
    CrossrefPubMedGoogle Scholar
  • 45 Rinaldi L, Lisi F, Floccari A et al. Endometrial thickness as a predictor of pregnancy after in-vitro fertilization but not after intracytoplasmic sperm injection. Hum Reprod 1996; 11: 1538-1541
    CrossrefPubMedGoogle Scholar
  • 46 Bergh C, Hillensjo T, Nilsson L. Sonographic evaluation of the endometrium in in vitro fertilization IVF cycles. A way to predict pregnancy?. Acta Obstet Gynecol Scand 1992; 71: 624-628
    CrossrefPubMedGoogle Scholar
  • 47 Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol 2001; 18: 258-263
    CrossrefPubMedGoogle Scholar
  • 48 Jarvela IY, Sladkevicius P, Kelly S et al. Evaluation of endometrial receptivity during in-vitro fertilization using three-dimensional power Doppler ultrasound. Ultrasound Obstet Gynecol 2005; 26: 765-769
    CrossrefPubMedGoogle Scholar
  • 49 Schild RL, Knobloch C, Dorn C et al. Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil Steril 2001; 75: 361-366
    CrossrefPubMedGoogle Scholar
  • 50 Kumbak B, Erden HF, Tosun S et al. Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm. Reprod Biomed Online 2009; 18: 79-84
    CrossrefPubMedGoogle Scholar
  • 51 Quintero RB, Sharara FI, Milki AA. Successful pregnancies in the setting of exaggerated endometrial thickness. Fertil Steril 2004; 82: 215-217
    CrossrefPubMedGoogle Scholar
  • 52 Kovacs P, Matyas S, Boda K et al. The effect of endometrial thickness on IVF/ICSI outcome. Hum Reprod 2003; 18: 2337-2341
    CrossrefPubMedGoogle Scholar
  • 53 Kovachev E, Ganchev Z, Cherneva S et al. [Measurement of endometrial volume and endometrial thickness for assessment of endometrial receptivity in assisted reproductive techniques]. Akush Ginekol 2005; 2: 27-33
    PubMedGoogle Scholar
  • 54 Schild RL, Indefrei D, Eschweiler S et al. Three-dimensional endometrial volume calculation and pregnancy rate in an in-vitro fertilization programme. Hum Reprod 1999; 14: 1255-1258
    CrossrefPubMedGoogle Scholar
  • 55 Smith B, Porter R, Ahuja K et al. Ultrasonic assessment of endometrial changes in stimulated cycles in an in vitro fertilization and embryo transfer program. J In Vitro Fert Embryo Transf 1984; 1: 233-238
    CrossrefPubMedGoogle Scholar
  • 56 Sher G, Herbert C, Maassarani G et al. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in-vitro fertilization and embryo transfer (IVF/ET). Hum Reprod 1991; 6: 232-237
    PubMedGoogle Scholar
  • 57 Singh N, Bahadur A, Mittal S et al. Predictive value of endometrial thickness, pattern and sub-endometrial blood flows on the day of hCG by 2D doppler in in-vitro fertilization cycles: A prospective clinical study from a tertiary care unit. J Hum Reprod Sci 2011; 4: 29-33
    CrossrefPubMedGoogle Scholar
  • 58 Kuc P, Kuczynska A, Topczewska M et al. The dynamics of endometrial growth and the triple layer appearance in three different controlled ovarian hyperstimulation protocols and their influence on IVF outcomes. Gynecol Endocrinol 2011; 27: 867-873
    CrossrefPubMedGoogle Scholar
  • 59 Diedrich K, Strowitzki T, Kentenich H. The state of reproductive medicine in Germany. Geburtsh Frauenheilk 2012; 72: 225-234
    Article in Thieme ConnectPubMedGoogle Scholar