Prospective evaluation of endometrial thickness as a predictor of pituitary down-regulation after gonadotropin-releasing hormone analogue administration in an in vitro fertilization program

被引:37
作者
Barash, A [1 ]
Weissman, A [1 ]
Manor, M [1 ]
Milman, D [1 ]
Ben-Arie, A [1 ]
Shoham, Z [1 ]
机构
[1] Hebrew Univ Jerusalem, Sch Med, Kaplan Med Ctr, In Vitro Fertilizat Unit,Dept Obstet & Gynecol, IL-76100 Rehovot, Israel
关键词
endometrial thickness; ultrasound; GnRH-a; down-regulation; IVF;
D O I
10.1016/S0015-0282(97)00542-6
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective: To determine whether pituitary down-regulation after gonadotropin-releasing hormone analogue (GnRH-a) administration can be accurately predicted by transvaginal ultrasonographic measurement of endometrial thickness. Design: Prospective study. Setting: An IVF unit of an academic medical center. Patient(s): One hundred eighty-one patients undergoing 265 NF-ET treatment cycles using GnRH-a in the long protocol. Main Outcome Measure(s): Serum concentrations of E-2 were determined, and endometrial thickness was measured by transvaginal sonography. The accuracy of endometrial thickness for predicting pituitary down-regulation was calculated. Result(s): Pituitary down-regulation, defined as a serum E-2 concentration of less than or equal to 55 pg/mL, was achieved in 77% (204 of 265) of the cycles. An endometrial thickness of less than or equal to 6 mm was found in 92.2% (188 of 204) of cycles in which down-regulation was achieved. An estradiol level of less than or equal to 55 pg/mL was present in 95.9% (188 of 196) of cycles with endometrial thickness of less than or equal to 6 mm. Conclusion(s): A state of relative hypoestrogenism after GnRH-a administration, indicative of pituitary down-regulation, can be predicted with a high degree of accuracy by ultrasonographic measurement of endometrial thickness. Thus, routine testing for serum E-2 concentration may be safely omitted. This may allow further simplification of IVF protocols and increase both cost-effectiveness and patients' convenience. (C) 1998 by American Society for Reproductive Medicine.
引用
收藏
页码:496 / 499
页数:4
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