Adjusting progesterone (P) dosage to compensate for a non-homogeneous hyperechogenic (HH) echo pattern three days after embryo transfer

Abstract

Adjusting progesterone (P) dosage to compensate for a non-homogeneous hyperechogenic (HH) echo pattern three days after embryo transfer J.H. Check 1,2 , C. Dietterich 2 , M. Lowney 2 , V. Sapoznikov 2 , R. Difilippo 2 , J. Giangreco 2 , K. Clarkson 2 1Cooper Medical School of Rowan University, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ 2Cooper Institute For Reproductive Hormonal Disorders, P.C., Mt. Laurel, NJ (USA) Summary Purpose: To determine if in the modern era failing to attain a homogenous hyperechogenic (HH) pattern three days after embryo transfer is still associated with a lower pregnancy rates. The study evaluates the efficacy of adding extra progesterone (P) at the time of the non-HH pattern. Materials and Methods: A five-year retrospective cohort analysis was performed evaluating two age groups (≤ 34 vs. 35-39 years). If an HH pattern was not attained, 50 mg IMP was added to the vaginal P supplementation already given in the IVF-ET cycle. The first two IVF cycles were evaluated. Results: There was no difference in live delivered pregnancy rates in younger women not attaining the HH pattern but it was lower in those aged 36-39 years. Conclusions: A randomized study adding extra IM P or not in women aged 36-39 or even the younger women is needed to determine if adding extra IM P improves the pregnancy rates or not. Key words: Mid-luteal phase; Endometrial echo pattern; In vitro fertilization; Live delivered pregnancy rate.