Journal of Clinical Case Reports

Persistence of the Central Endometrial Echo During the Midluteal Phase of the Cycle

Abstract

Abdel-Gadir A

Objective: To find factors possibly related to the persistence of a midluteal central endometrial echo usually associated with lower pregnancy rates.
Methodology: 2 groups of women with regular menstrual cycles were followed by transvaginal ultrasound scan examinations during the follicular and luteal phases of the cycle. One group consisted of 31 parous women who requested assisted reproduction treatment and gender selection for family completion. The other group consisted of 79 nulliparous women monitored during infertility investigations. There was no history of prior uterine surgery or recent hormonal medication. The age and body mass index of all women were recorded beforehand. Presence of polycystic ovaries, midcycle endometrial thickness, uterine arteries pulsatility index and ovulation time were recorded. Endometrial texture and serum progesterone level were examined 7-9 days after ovulation. All monitored indices were assessed in relation to the two studied groups and to the presence or absence of a central endometrial echo.
Results: No differences were detected between the two groups regarding age, body mass index, polycystic ovaries prevalence, midcycle endometrial thickness, midcycle uterine arteries pulsatility index or midluteal serum progesterone. A central midluteal endometrial echo was evident in 6 of 31 women in the parous group (19.4%) and 26 of 79 (32.9%) in the nulliparous group (p=0.119). It was significantly more common in women with polycystic ovaries (19 of 34, 55.9%) than the non-polycystic ovaries group (13 of 76, 17.1%); p<0.001. All other parameters examined had no significant correlation with the luteal phase persistent central endometrial echo.
Conclusion: Local uterine factors might be responsible for the persistent midluteal central endometrial echo as it had no significant correlation to the uterine arteries blood perfusion or midluteal serum progesterone. It might be corelated to endometrial hyperandrogenisation because of its significant correlation to polycystic ovaries. Other local possibilities need to be explored.