A total of 172 patients who underwent hysteroscopic assessment of the endometrium and then became pregnant, was analysed retrospectively to explore the relationship between endoscopic findings and early phase pregnancy outcome after implantation.Histological examination of the endometrium and assay of serum progesterone and oestrogen were carried out simultaneously with hysteroscopy. Of the remaining 160 patients, 62 (38.8%) were classified endoscopically as having `good' mid-secretory endometrium and 98 (61.3%) as `poor', between one and four cycles prior to the conception cycle.There were no clinical differences between these two groups, except that the frequency of patients with a history of early abortion was significantly higher in the `poor' group (25.5%) than in the `good' group (8.1%) ( 0.05).Of 160 pregnancies, 118 persisted successfully to live birth, but 42 ended in early pregnancy loss.All 172 patients who had undergone hysteroscopic examination of the endometrium at our University Hospital, Okinawa, Japan, between January 1993 and December 1997, and became pregnant, were considered for the study.Patients with chemical or subclinical abortion, i.e.
The maturation process of the endometrium is mediated by ovarian sex steroid hormones.In this context, it was felt to be of interest whether or not the hysteroscopic appearance of the endometrium is associated with early pregnancy loss as well as with implantation failure of fertilized ovum.The aims of the present study using hysteroscopic assessment of the mid-secretory phase endometrium were: (i) to explore whether or not there is a relationship between hysteroscopic findings and early phase pregnancy outcome after implantation; and (ii) to compare endoscopic findings with histological and endocrinological backgrounds.At diagnosis of pregnancy, the mean age of the patients was 34.8 ± 3.8 (range 25–44) years.Of 172 pregnancies, 77 were spontaneous, while 95 were assisted by ovulation induction, IVF/embryo transfer and intrauterine insemination by the husband (IUI).
Serum progesterone and oestradiol, taken on the day of hysteroscopy, were measured in 83 patients by enzyme immunoassay kits (DPC Estradiol and Progesterone assay kits; Diagnostic Products Corporation. The normal values for progesterone and oestradiol in the luteal phase (days 3–15 after ovulation) were 0.2–31.6 ng/ml (SI conversion factor = 3.18) and 0.009–0.230 ng/ml (SI conversion factor = 3.671) respectively.