Estradiol Supplement Therapy during Controlled Ovarian Hyperstimulation in Patients of IVF-ET with Thin Endometrium

Han, K S; Kwon, H C; Hwang, K J; Lee, C H; Yang, J I; Kim, M R; Oh, K S

Abstract

OBJECTIVE
To evaluate the endometrial response and the receptivity of estradiol supplement in patients with abnormally thin endometrium who were undergoing IVF-ET.
METHODS
Design: A prospective, nonrandomized study. Setting: Ajou University School of Medicine, Suwon, Korea. Patients: A total of 772 IVF-ET cycles divided into four groups by endometrial thickness on the day of hCG injection and applied protocols. Interventions: Estradiol supplement before/during COH using GnRH agonist long protocol in patients with less than 7mm endometrial thickness from the previous cycle on the day of hCG administration. Main Outcome Measures: Incidence of patients with improved endometrial thickness 7mm, quality of transferred embryos and pregnancy rate were compared. Result[s]: Patients with thin endometrium [<7mm] in their previous cycle had a 74.1% [20/27] chance in cycles with estradiol supplement before/during COH to develop optimal endometria more than 7mm comparable to a 78.3% [18/23] chance in subsequent cycles of long term estrogen replacement. The pregnancy rate was markedly improved after the treatment protocol[9.5% vs. 30.7%]. Conclusion[s]: In cases where the endometrium is not adequate in the previous cycle, it is suggested that estradiol supplement before/during COH using GnRH agonist long protocol is effective.