Determining the Best Appropriate Level of Endometrial Thickness in the Outcome of Intra-Cytoplasmic Sperm Injection

The success rate of intra-cytoplasmic sperm injection (ICSI) is dependent not only on egg and sperm quality but also is related to endometrial receptivity. Today one of the main obstacles in the treatment of infertility is reduced implantation rates in infertility treatment cycles, despite having some good quality embryos. Therefore, this study was designed to determine the best appropriate level of endometrial thickness on intra-cytoplasmic sperm injection outcome.

A cross-sectional study was performed on 198 patients in ICSI/ET cycles in Fatemeh-Zahra Infertility center of Babol University of medical science (Babol, Iran) during 2009-2010. Sonography feature of the endometrium (thickness and pattern) and various other variables (maternal age, cause and duration of infertility and number of retrieved oocyte) in pregnant (according to positive B-HCG test and presence of fetal heart beat on vaginal sonography) and non pregnant patients were compared.

A total of 198 cycles were analyzed. Pregnancy rate was 46 (23.2%). Most pregnancy rate (50%) was among patients with an endometrial thickness 9.2-11.7 mm. Duration, type and etiology of infertility, endometrial pattern and number of retrieved oocyte were not correlated to ICSI outcome. Endometrial thickness and maternal age is a predictive factor of success rate in ICSI treatment cycles (p<0.05).

Endometrial thickness is a good predictive factor for ICSI outcome. We can decide for embryo transfer or freezing if endometrial thickness and pattern are inappropriate.