Background: Assisted reproductive treatment (ART) cycle is an expensive procedure with low implantation and pregnancy rate; therefore, it is necessary to evaluate the predictors of success in these patients.

Objective: The relationship between endometrial echopattern and pregnancy rate was evaluated.

Methods: The endometrial echopattern was analyzed prospectively on the day of human chorionic gonadotropin (HCG) administration in 280 in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles with 8-14 mm endometrial thickness at Royan institute in 2013-2014. Based on echopattern, three groups were developed: pattern A (Triple line), pattern B (Heterogeneous-echogen) and pattern C (Homogeneous-echogen). Pregnancy rate (PR) was compared between all groups. Data was analyzed using SPSS (v.18, Chicago, IL, USA), and descriptive tests such as Chi-square and analytical tests like logistic regression, for controlling confounder variables like age.

Results: Among 280 patients finally evaluable, the distribution of endometrial echopattern on the day of HCG administration was 127 patients (45.4%) in group A, 98 patients (35%) in group B and 55 patients (19.6%) in group C. The highest PR per transfer pertained to group A (49.6%), and the lowest to group B (32.7%).

Conclusion: The presence of pattern A (Triple line) appears more likely to favor pregnancy. Therefore, ultrasonographic evaluation of endometrial echopattern on the day of HCG administration has prognostic value in clinical settings for predicting implantation in ART cycle