“role of hormones and cytokines in creating an attractive endometrial bed for fertility - a quasi study”

Research Article
Rehana Rehman,Shireen Jawed, Mehwish Hussain ,Shah Jahan Katpar, and Mukhtiar Baig
Intracy to plasmic sperm injection (ICSI), ovulation induction, endometrial thickness, embryo implantation

Objective: To determine predictors of endometrial thickness required for implantation of embryo after intracytoplasmic sperm injection (ICSI).

Subjects and Methods: It was a quasi experimental design conducted from July 2011 till June 2012 in “Islamabad Clinic Serving Infertile Couples”. During treatment protocol, on ovulation induction day (OI), number of oocytes and endometrial thickness was measured by Trans vaginal scan and estimation of serum estradiol (E2), progesterone (P) and interleukin Iβ (IL-I β) levels by enzyme linked Immunosorbent assay. Pregnancy was detected 10 days after blastocyst transfer by beta hCG value of more than 25 mIU/ml. Cut off value of 8 mm endometrial thickness for acquiring clinical pregnancy was declared by receiver operator curve. Univariable and multivariable logistic regression of endometrial thickness was applied.

Results: Females age was 32.1 ± 4.7 years, BMI 24.2 ± 3.7 kg /m2and endometrial thickness 8.6 ± 3.4 mm (mean ± SD). Out of 282 patients, 101 (36%) had positive pregnancy; 95 (94.1%) had thickness ≥ 8mm. Thickness was predicted by a rise in IL-Iβ and E2 (OR=1.017, 95% CI =1.008-1.026, p < 0.001and OR = 1.002, 95% CI = 1.000 – 1.003, p = 0.029) respectively.

Conclusion: The appropriate endometrial thickness was facilitated by coordination of endocrine and immune mechanisms with a high E2 and IL-Iβ that made endometrium amenable and creating it as a suitable bed for embryo implantation.