Does A Hyperechogenic Endometrial Mass In The Uterus During Controlled Ovarian Stimulation Affect Assisted Reproductive Technology Cycle Outcomes?

Objective:Healthy embryos and endometrial receptivity are keys to the success of in-vitro fertilization and embryo transfer(IVF-ET).Transvaginal ultrasonography(TVU)is the test of choice for evaluating endometrial receptivity and has high sensitivity for detecting any pathology.Abnormal Transvaginal ultrasonography(TVU)findings oft he endometrium is of great potential concern to clinicians involved in assisted reproductive technology(ART).Observation of a hyperechogenic endometrial mass(HEM)during controlled ovarian stimulation(COS)in an IVF or intracytoplasmic sperm injection(ICSI)cycle is a dilemma for ART clinicians.Here we investigated whether a HEM detected by TVU during COS would affect ART cycle outcomes.Study design:We analyzed all data from patients who underwent IVF or ICSI treatment cycles from January 1,2009 to December 31,2016 in our institution.Patients diagnosed with a hyperechogenic endometrial mass(HEM)in the uterus by means of TVU during COS were included.Each woman was matched with two control subjects of similar age(±1 year),in terms of the number of cycles,type of infertility(primary or secondary),type of protocol used for COS,but with no HEM identified by TVU.Baseline characteristics,COS response,and pregnancy outcomes after ET were compared.Student's t tests were used to test normally distributed numerical data and Pearson's Chi-squared test was used to test categorical data;P<0.05 was considered statistically significant.Results During the study period,1088 patients were diagnosed with a HEM in the uterus by means of TVS during COS before fresh IVF-ET or ICSI-ET(ART)cycles.Of these patients,426 met the inclusion criteria and were matched with 852 control subjects.Baseline characteristics showed no significant differences between the two groups.The peak endometrial thickness was significantly higher in the experimental group than in the control group(1.2±0.2 cm vs.1.1±0.2 cm,P<0.001).The live birth rates were 43.7%vs 46.2%in the experimental and control groups,respectively.There were no significant between-group differences in the rates of biochemical or clinical pregnancy or abortions at any stage.Conclusions Newly diagnosed hyperechogenic endometrial masses<18 mm in diameter monitored by TVU did not impair the outcomes of ART following COS in this study.If other conditions are suitable,completion of ART cycles should be the appropriate approach for such cases.