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Correlative analyze of predictable factors of successful implantation in assisted reproduction programme

Papić-Obradović Milena (Ginekološko-akušerska klinika 'Narodni front', Beograd)
Dragojević-Dikić Svetlana (Ginekološko-akušerska klinika 'Narodni front', Beograd)
Mitrović Ana (Ginekološko-akušerska klinika 'Narodni front', Beograd)
Papić Dušan (Kliničko-bolnički centar 'Zvezdara', Beograd)

INTRODUCTION Endometrial receptivity as isolated predictive factor of successful implantation, with its specifity is determined with numbered factors. PURPOSE Purpose of this study was to evaluate significance and correlation between relevant factors using appropriate statistical analyses on term of embryo implantation. MATERIAL AND METHODS Evaluated group contained 85 women whom according different causes of infertility have been determined for assisted reproduction program. Analysed measurements were endometrial thickness, assessed hyperechogenity in relation with absolute endometrial thickness (HEA relation) and uterine blood flow (pulsatile index - Pi). Simultaneously were analyzed serum estradiol (E2; pg/ml) and progesteron (P; nmol/l) levels. After these evaluations achieved results were processed with standard statistical pack. Beside that were applied parameter and nonparameter tests with aim to test significancy of difference and multiple regressive analyse (Stepwise). RESULTS Resulted measured parameters have been presented in basic analyse as middle value (Xrs) from all measurements +SD (standard deviation) and significance of difference is tested by mentioned statistical tests (Table 1). Application of Stepwise analyse, "step by step", has used parameter by parameter based on value which has decreased variability and based on achieved correlative coefficient between dependent uneven and complex of independent uneven values. This procedure confirmes best correlation between HEA relation and serum progesteron levels and HEA relation in correlation with associated values: P, E2 and endometrial thickness (Table 1). DISCUSSION Investigation provided till now shows that embryo quality and endometrial receptivity with highest probability determine success of applied assisted reproduction, successful embryonal implantation There is assessed influence of endometrial receptivity represented trough HEA relation using manyfolded regressive analyse where qualitative endometryal value has been looked with dependency with other parameters gives picture for high determinancy with hormonal activity and with stimulative ovarian activity. This determinacy could be viewed mostly through serum progesteron levels on day of HCG administration. Correlative relation between qualitative endometrial characteristics on day of HCG administration has highes value related to progesteron levels. CONCLUSION Results presented with this research confirm once again complexity characteristic for factors that play final role in embryo implantation in IVF program. There is presented only one aspect related with this problem with aim to contribute quantification importance and assessment rate of mutual influence these factors known till now as relevant.

Keywords: in vitro fertilization, endometrium, progesterone, estradiol