Objective: To attempt the monitoring of ovulation induction solely with ultrasound (US).
Design: Using serial US measurements to monitor ovulation induction using human menopausal gonadotropin and human chorionic gonadotropin (hCG), in comparison with estradiol (E2) concentrations that became available at the end of each cycle.
Setting: Specialist Reproductive Endocrine Unit.
Patients, participants: Twenty hypogonadotropic and 29 ultrasonically diagnosed polycystic ovary patients.
Main outcome measure: Follicular growth, uterine measurements, endometrial thickness, and serum E2 concentrations.
Results: Follicular growth, uterine measurements, and endometrial thickness correlated strongly with E2 concentrations (P less than 0.0001). The endometrium on the day of hCG administration was significantly thicker (P less than 0.01) in the conception (n = 27) compared with the nonconception cycles (n = 87), whereas no significant difference were observed in serum E2 concentrations. No pregnancy was observed when hCG had been administered when the endometrial thickness was less than or equal to 7 mm. Midluteal endometrial thickness of greater than or equal to 11 mm was found to be a good prognostic factor for detecting early pregnancy (P less than 0.008).
Conclusions: Serial US examinations used alone have proven to be safe and highly efficient. It also has a unique ability to detect pregnancy in the midluteal phase.