Artigos Originais Archives - Revista Brasileira de Ginecologia e Obstetrícia
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):174-180
DOI 10.1590/S0100-72032005000400003
PURPOSE: to determine the prevalence of group B Streptococcus (GBS) in pregnant women in the third trimester of pregnancy and explore the factors potentially associated with colonization. METHODS: a sample of 273 pregnant women in the third trimester of pregnancy, from the prenatal care center in Southern Brasil, was investigated. Vaginal and anorectal samples were collected and innoculated in Todd-Hewitt selective broth supplemented with 10 µg/mL colistin and 15 µg/mL nalidixic acid and afterwards cultured on defibrinated sheep blood agar plates. All suspected colonies were submitted to the agglutination test for detection of the specific group B antigen. The Camp test was used for GBS identification in non-hemolytic varieties. Demographic, socioeconomic, reproductive, and clinico-obstetric data were also analyzed. Prevalence ratio (PR) was used as risk measurement. Confidence interval was considered significant at the level of 95% (alpha=0.05). RESULTS: prevalence of Streptococcus (GBS) colonization amounted to 21.6% (59), 9.9% (27) of pregnant women showing positivity in both sites; vaginal site colonization was found in 6.95% (19) of the women and 4.75% (13) of the samples showed positivity only in the anal site. GBS prevalence was slightly higher in pregnant women under 20 years, in those with less schooling and in primiparae and was twice as high among those who did not reported spontaneous abortion, but with no statistical significance. No difference was found in GBS prevalence according to the history of sexually transmittted diseases and tabagism. When analyzed together, the factors detected as potentially associated with colonization by GBS were: primiparae over 30 years (PR=1.55) and women with more than one sexual partner and increased frequency of sexual activity (p<0.05) (55,6 vs 20.5%; p<0.05). No difference regarding prevalence was found to exist in relation to the history of sexually transmitted diseases, previous spontaneous abortion and tabagism. CONCLUSION: these results confirm the need for routine collection for GBS culture from both sites (vaginal and anal) in all pregnant women in the third trimester of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):174-180
DOI 10.1590/S0100-72032005000400003
PURPOSE: to determine the prevalence of group B Streptococcus (GBS) in pregnant women in the third trimester of pregnancy and explore the factors potentially associated with colonization. METHODS: a sample of 273 pregnant women in the third trimester of pregnancy, from the prenatal care center in Southern Brasil, was investigated. Vaginal and anorectal samples were collected and innoculated in Todd-Hewitt selective broth supplemented with 10 µg/mL colistin and 15 µg/mL nalidixic acid and afterwards cultured on defibrinated sheep blood agar plates. All suspected colonies were submitted to the agglutination test for detection of the specific group B antigen. The Camp test was used for GBS identification in non-hemolytic varieties. Demographic, socioeconomic, reproductive, and clinico-obstetric data were also analyzed. Prevalence ratio (PR) was used as risk measurement. Confidence interval was considered significant at the level of 95% (alpha=0.05). RESULTS: prevalence of Streptococcus (GBS) colonization amounted to 21.6% (59), 9.9% (27) of pregnant women showing positivity in both sites; vaginal site colonization was found in 6.95% (19) of the women and 4.75% (13) of the samples showed positivity only in the anal site. GBS prevalence was slightly higher in pregnant women under 20 years, in those with less schooling and in primiparae and was twice as high among those who did not reported spontaneous abortion, but with no statistical significance. No difference was found in GBS prevalence according to the history of sexually transmittted diseases and tabagism. When analyzed together, the factors detected as potentially associated with colonization by GBS were: primiparae over 30 years (PR=1.55) and women with more than one sexual partner and increased frequency of sexual activity (p<0.05) (55,6 vs 20.5%; p<0.05). No difference regarding prevalence was found to exist in relation to the history of sexually transmitted diseases, previous spontaneous abortion and tabagism. CONCLUSION: these results confirm the need for routine collection for GBS culture from both sites (vaginal and anal) in all pregnant women in the third trimester of pregnancy.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):181-188
DOI 10.1590/S0100-72032005000400004
PURPOSE: to estimate the prevalence of Family Health Program postpartum depression (PPD) and its association with minor mental disorders (MMD) among women attended in two (FHP) PSF units, in the city of São Paulo, and to identify risk factors associated with PPD. METHODS:a cross-sectional study with 70 postpartum women from two FHP units (Fazenda da Juta II and Jardim Sinhá), from October 2003 to February 2004. The following instruments were used: questionnaire with socio-demographical-economic data and obstetric and perinatal data; Self-Report Questionnaire 20 (SRQ-20), for screening of MMD, and Edinburgh Post-Natal Depression Scale (EPDS), for evaluation of PPD. To verify association between explanatory variables and PPD, Student's t test, chi2 or linear trend chi2 were utilized when indicated. To evaluate concordance between scales (EPDS and SRQ-20) kappa (kappa) coefficient correlation was used. RESULTS:the prevalence of PPD and MMD was 37.1%. Scales presented a good concordance (kappa=0.75). The explanatory variables age, ethnicity, years of education, profession, and marital status, besides partner's profession and years of education, familiar income, number of pregnancies, parity, miscarriage, number of alive children, premature deliveries, gestational age, type of delivery, planning of actual pregnancy, score of Apgar (first and five minutes), newborn sex and weight, and breastfeeding did not show significant statistical association. A greater perception of social support from the partner was associated with lower prevalence of PPD (p=0.03). CONCLUSION: because of its high prevalence and negative impact upon mother and child, it is worthwhile to sensitize health care professionals about the importance of PPD
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):181-188
DOI 10.1590/S0100-72032005000400004
PURPOSE: to estimate the prevalence of Family Health Program postpartum depression (PPD) and its association with minor mental disorders (MMD) among women attended in two (FHP) PSF units, in the city of São Paulo, and to identify risk factors associated with PPD. METHODS:a cross-sectional study with 70 postpartum women from two FHP units (Fazenda da Juta II and Jardim Sinhá), from October 2003 to February 2004. The following instruments were used: questionnaire with socio-demographical-economic data and obstetric and perinatal data; Self-Report Questionnaire 20 (SRQ-20), for screening of MMD, and Edinburgh Post-Natal Depression Scale (EPDS), for evaluation of PPD. To verify association between explanatory variables and PPD, Student's t test, chi2 or linear trend chi2 were utilized when indicated. To evaluate concordance between scales (EPDS and SRQ-20) kappa (kappa) coefficient correlation was used. RESULTS:the prevalence of PPD and MMD was 37.1%. Scales presented a good concordance (kappa=0.75). The explanatory variables age, ethnicity, years of education, profession, and marital status, besides partner's profession and years of education, familiar income, number of pregnancies, parity, miscarriage, number of alive children, premature deliveries, gestational age, type of delivery, planning of actual pregnancy, score of Apgar (first and five minutes), newborn sex and weight, and breastfeeding did not show significant statistical association. A greater perception of social support from the partner was associated with lower prevalence of PPD (p=0.03). CONCLUSION: because of its high prevalence and negative impact upon mother and child, it is worthwhile to sensitize health care professionals about the importance of PPD
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):189-196
DOI 10.1590/S0100-72032005000400005
PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):189-196
DOI 10.1590/S0100-72032005000400005
PURPOSE: to create a predictive model for cesarean section at the "Professor Monteiro de Morais Maternity" after evaluation of antepartum risk factors of the pregnant women who delivered from September 1, 1999 to August 31, 2000, and then, to verify the efficacy of indication for cesarean section. METHODS: a longitudinal, case control study with 3.626 pregnant women was performed to identify the antepartum risk factors for cesarean section in the period from September 1, 1999 to August 31, 2000. Thereafter an ideal model able to quantify the risk for cesarean section for each patient in the presence of one or more risk factor was created. Then, the model was applied to the patients of the study in order to verify the efficacy of indication for cesarean section. RESULTS: the baseline risk for cesarean section was 15.2%. The concordance between the percentage estimated through logistic model and cesarean delivery was 86.6%. CONCLUSIONS: the logistic model was able to identify the baseline risk for cesarean section and to quantify the increase in risk for cesarean section in each patient when risk factors were introduced in the model. The model can be considered efficient and able to predict cesarean section because the agreemant between the prediction and the correct indication was 86.6%, and 53.6% of the patients who had vaginal delivery did not have any risk factor for cesarean section.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):197-203
DOI 10.1590/S0100-72032005000400006
PURPOSE: to apply a severity score to cases of severe maternal morbidity (SMM) and to compare the classification criteria. METHODS: a control-case study was performed as a secondary analysis of cases of SMM in a tertiary level maternity unit for a period of 12-month. A specific score for assessing the degree of severity was applied to cases identified as SMM. Twenty cases of near miss maternal morbidity (higher severity) were compared to 104 control cases (lower severity) of other severe morbidities, regarding risk factors, primary determinants and assistance requirements. Analyses were performed with means and proportions, using Student's t, Wilcoxon and chi2 statistical tests, and estimations of OR and 95% CI. RESULTS: the higher severity (near miss) was identified in 16.1% of cases and the history of abortion was the only factor statistically associated with it (OR=3.41, 95% CI 1.08-10.79). In fact, the indices of assistance complexity were more frequent in the near-miss morbidity group, which also presented less hypertension (30% against 62.5%) and more hemorrhage (35.5% against 10.6%) as primary determinant factors of severe morbidity. CONCLUSIONS: the higher severity of maternal morbidity was associated with a history of abortion and with hemorrhage as a cause. The applied score was able to identify a higher severity subgroup (near miss), which needs more complex professional and institutional care in order to avoid the occurrence of death.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):197-203
DOI 10.1590/S0100-72032005000400006
PURPOSE: to apply a severity score to cases of severe maternal morbidity (SMM) and to compare the classification criteria. METHODS: a control-case study was performed as a secondary analysis of cases of SMM in a tertiary level maternity unit for a period of 12-month. A specific score for assessing the degree of severity was applied to cases identified as SMM. Twenty cases of near miss maternal morbidity (higher severity) were compared to 104 control cases (lower severity) of other severe morbidities, regarding risk factors, primary determinants and assistance requirements. Analyses were performed with means and proportions, using Student's t, Wilcoxon and chi2 statistical tests, and estimations of OR and 95% CI. RESULTS: the higher severity (near miss) was identified in 16.1% of cases and the history of abortion was the only factor statistically associated with it (OR=3.41, 95% CI 1.08-10.79). In fact, the indices of assistance complexity were more frequent in the near-miss morbidity group, which also presented less hypertension (30% against 62.5%) and more hemorrhage (35.5% against 10.6%) as primary determinant factors of severe morbidity. CONCLUSIONS: the higher severity of maternal morbidity was associated with a history of abortion and with hemorrhage as a cause. The applied score was able to identify a higher severity subgroup (near miss), which needs more complex professional and institutional care in order to avoid the occurrence of death.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):204-209
DOI 10.1590/S0100-72032005000400007
PURPOSE: to analyze the effects of isoflavones and estrogens on the morphology, morphometry and VEGF expression of the adult female rat mammary gland. METHODS: Forty-five adult female rats were oophorectomized; 28 days after surgery they were divided into 3 groups of 15 animals each: CON - control (treated with propylenoglycol); ISO - isoflavones (100 mg/kg) and CEE - conjugated equine estrogens (50 µg/Kg). Drugs or vehicle were given orally once a day for 60 days. After this, the animals were killed and the first pair of inguinal mammary glands was immediately removed; part of the material was processed for routine histological study and the remaining tissue was frozen for further analyses of the expression of VEGF mRNA by means of the RT-PCR technique. RESULTS: We observed that mammary ducts were atrophic in the control (CON) and isoflavone-treated (ISO) groups. In these groups the mammary glands were composed of a large concentration of adipose tissue with some ducts and rare alveolar structures. In the CEE group the ducts were well developed with many buds and alveolar structures. The number of mammary gland alveoli was higher in CEE than in the other groups (CON = 1.4 ± 2.1; ISO = 1.6 ± 3.8; CEE = 12.3 ± 7.1 alveoli/mm²; p<0.05%); also, the cell volume was higher (CON = 14.9 ± 4.9; ISO = 11.4 ± 6.9; CEE = 27.4 ± 9.7 µm³, p< 0.05%). The same was observed with regard to the number of blood vessels (CON = 16.4 ± 1.5; ISO = 18.4 ± 2.1; CEE = 37.1 ± 4.1 vessels/mm², p< 0.05). The expression of VEGF in the CEE group was higher than in the other groups, which did not significantly differ from each other in this respect. CONCLUSION: Our data did not show any proliferation effect in the mammary tissue of adult oophorectomized rats treated with isoflavones (100 mg/kg) during 60 days.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):204-209
DOI 10.1590/S0100-72032005000400007
PURPOSE: to analyze the effects of isoflavones and estrogens on the morphology, morphometry and VEGF expression of the adult female rat mammary gland. METHODS: Forty-five adult female rats were oophorectomized; 28 days after surgery they were divided into 3 groups of 15 animals each: CON - control (treated with propylenoglycol); ISO - isoflavones (100 mg/kg) and CEE - conjugated equine estrogens (50 µg/Kg). Drugs or vehicle were given orally once a day for 60 days. After this, the animals were killed and the first pair of inguinal mammary glands was immediately removed; part of the material was processed for routine histological study and the remaining tissue was frozen for further analyses of the expression of VEGF mRNA by means of the RT-PCR technique. RESULTS: We observed that mammary ducts were atrophic in the control (CON) and isoflavone-treated (ISO) groups. In these groups the mammary glands were composed of a large concentration of adipose tissue with some ducts and rare alveolar structures. In the CEE group the ducts were well developed with many buds and alveolar structures. The number of mammary gland alveoli was higher in CEE than in the other groups (CON = 1.4 ± 2.1; ISO = 1.6 ± 3.8; CEE = 12.3 ± 7.1 alveoli/mm²; p<0.05%); also, the cell volume was higher (CON = 14.9 ± 4.9; ISO = 11.4 ± 6.9; CEE = 27.4 ± 9.7 µm³, p< 0.05%). The same was observed with regard to the number of blood vessels (CON = 16.4 ± 1.5; ISO = 18.4 ± 2.1; CEE = 37.1 ± 4.1 vessels/mm², p< 0.05). The expression of VEGF in the CEE group was higher than in the other groups, which did not significantly differ from each other in this respect. CONCLUSION: Our data did not show any proliferation effect in the mammary tissue of adult oophorectomized rats treated with isoflavones (100 mg/kg) during 60 days.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):210-215
DOI 10.1590/S0100-72032005000400008
PURPOSE: to verify the behavior of the abdominal and perineal musculature in respiratory changes induced in 15 nulliparous women without previous history of perineal or respiratory failures, with age ranging from 20 to 26 years (22.9±1.83). METHODS: the electrical abdominal and perineal activities were analyzed simultaneously through surface electromyography and perineal pressure (PP) obtained through digital biofeedback. The volunteers were told to accomplish three types of respiratory maneuvers: maximum inspiration (PImax), maximum expiration (PEmax) and Valsalva (VM), at random. The electromyographic signs were collected by the AqDados® (4.4) software for binary language ASCII, being processed later using the Matlab® (6.5.1) software. The statistical analysis of the envoltory (EN) of the signal was accomplished through Spearman correlation and Kruskal-Wallis test, and the level of significance was set at 5% (p<0.05). RESULTS: it was observed that PP was larger in PImax (2.98±2,38), followed by VM (29.10±10.68), both being overcome by PEmax (38.22±9,98) (p<0.01). A positive correlation between PEmax and PP (p<0.01), as well as between EN of the perineal and abdominal musculature in PEmax and PImax (p<0.05 and p=0,03, respectively) could be shown. The results regarding VM were not significant, when PP and EN were analyzed. CONCLUSION: it was possible to identify the presence of abdomino-pelvic synergy during the execution of breathing maneuvers, especially in relation to PEmax.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):210-215
DOI 10.1590/S0100-72032005000400008
PURPOSE: to verify the behavior of the abdominal and perineal musculature in respiratory changes induced in 15 nulliparous women without previous history of perineal or respiratory failures, with age ranging from 20 to 26 years (22.9±1.83). METHODS: the electrical abdominal and perineal activities were analyzed simultaneously through surface electromyography and perineal pressure (PP) obtained through digital biofeedback. The volunteers were told to accomplish three types of respiratory maneuvers: maximum inspiration (PImax), maximum expiration (PEmax) and Valsalva (VM), at random. The electromyographic signs were collected by the AqDados® (4.4) software for binary language ASCII, being processed later using the Matlab® (6.5.1) software. The statistical analysis of the envoltory (EN) of the signal was accomplished through Spearman correlation and Kruskal-Wallis test, and the level of significance was set at 5% (p<0.05). RESULTS: it was observed that PP was larger in PImax (2.98±2,38), followed by VM (29.10±10.68), both being overcome by PEmax (38.22±9,98) (p<0.01). A positive correlation between PEmax and PP (p<0.01), as well as between EN of the perineal and abdominal musculature in PEmax and PImax (p<0.05 and p=0,03, respectively) could be shown. The results regarding VM were not significant, when PP and EN were analyzed. CONCLUSION: it was possible to identify the presence of abdomino-pelvic synergy during the execution of breathing maneuvers, especially in relation to PEmax.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):216-221
DOI 10.1590/S0100-72032005000400009
PURPOSE: to identify the relationship between serum levels of leptin and the levels of estradiol and follicle-stimulating hormone (FSH) in women with pituitary suppression and to evaluate its possible interference on the reproductive axis. METHODS: a total of 64 patients submitted to controlled ovarian hyperstimulation with recombinant FSH for assisted reproduction, due to a male or tubal factor, and 20 patients using estradiol valerate, for endometrial preparation in order to be submitted to oocyte donation treatment were studied. All patients used GnRH analogues before starting treatment in order to avoid premature LH surge. Data were analyzed statistically by the chi2 test, Student's t-test and the Pearson correlation test, when appropriate, with the level of significance set at p<0,05. RESULTS: it was observed that leptin levels correlated with body mass index (BMI) even though they had not influenced growth rate of these hormones. A positive correlation was observed between estradiol and leptin levels in both groups, as leptin levels increased from 10.42 to 15.68 ng/mL in the FSH group and from 11.09 to 14.5 ng/mL in the estradiol group, following estradiol increase. The growth rate of leptin was higher in women with higher estradiol levels, i.e., who had induced cycles with recombinant FSH, than in those who received estradiol valerate (159.60±58.01 and 136.73±34.17, respectively). CONCLOSION: we may state that leptin correlated with BMI and that both FSH and estradiol do interfere in the regulation of leptin production in women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(4):216-221
DOI 10.1590/S0100-72032005000400009
PURPOSE: to identify the relationship between serum levels of leptin and the levels of estradiol and follicle-stimulating hormone (FSH) in women with pituitary suppression and to evaluate its possible interference on the reproductive axis. METHODS: a total of 64 patients submitted to controlled ovarian hyperstimulation with recombinant FSH for assisted reproduction, due to a male or tubal factor, and 20 patients using estradiol valerate, for endometrial preparation in order to be submitted to oocyte donation treatment were studied. All patients used GnRH analogues before starting treatment in order to avoid premature LH surge. Data were analyzed statistically by the chi2 test, Student's t-test and the Pearson correlation test, when appropriate, with the level of significance set at p<0,05. RESULTS: it was observed that leptin levels correlated with body mass index (BMI) even though they had not influenced growth rate of these hormones. A positive correlation was observed between estradiol and leptin levels in both groups, as leptin levels increased from 10.42 to 15.68 ng/mL in the FSH group and from 11.09 to 14.5 ng/mL in the estradiol group, following estradiol increase. The growth rate of leptin was higher in women with higher estradiol levels, i.e., who had induced cycles with recombinant FSH, than in those who received estradiol valerate (159.60±58.01 and 136.73±34.17, respectively). CONCLOSION: we may state that leptin correlated with BMI and that both FSH and estradiol do interfere in the regulation of leptin production in women.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):7-11
DOI 10.1590/S0100-72032005000100003
PURPOSE: to compare pregnancy rates and mean endometrial thickness obtained with three protocols for induction of ovulation in cycles of intrauterine insemination (IUI). METHODS: one hundred and ten IUI cycles were retrospectively evaluated in the study, divided into three groups, according to the used ovulation induction protocols: 100 mg clomiphene citrate (CC) on days 3 to 7 of the cycle (CC group, n=24), 100 mg/day CC on days 3 to 7 of the cycle + 75 IU/day of human menopausal gonadotrophin (hMG) on days 3, 5 and 7 of the cycle (CC+hMG group, n=29), and 75 IU/day of hMG on days 3 to 8 of the cycle (hMG group, n=57). Statistical analysis was performed using Student's t test to compare the means and the c² test to compare the rates. Results were considered statistically significant at p<0.05. RESULTS: the patients' average age at the onset of the first cycle was 2340 years (mean age, 33.3 years). There were no statistically significant differences between groups. The mean endometrial thickness on the day of the human chorionic gonadotrophin (hCG) administration was significantly higher in the hMG group (10.2±0.2 mm), as compared with the CC and CC+hMG group (7.9±0.4 and 8.7±0.2 mm, respectively, p<0.001). The overall clinical pregnancy rate was 18.2%, and there were no statistically significant differences between the groups (CC group=12.5%; CC+hMG group=24.1% and hMG group=19.3%). CONCLUSION: the results indicate higher mean endometrial thickness in the hMG group as compared with the CC group and the CC+hMG group. There were no significant differences between clinical pregnancy rates obtained with each protocol (CC, CC+hMG and hMG).
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2005;27(1):7-11
DOI 10.1590/S0100-72032005000100003
PURPOSE: to compare pregnancy rates and mean endometrial thickness obtained with three protocols for induction of ovulation in cycles of intrauterine insemination (IUI). METHODS: one hundred and ten IUI cycles were retrospectively evaluated in the study, divided into three groups, according to the used ovulation induction protocols: 100 mg clomiphene citrate (CC) on days 3 to 7 of the cycle (CC group, n=24), 100 mg/day CC on days 3 to 7 of the cycle + 75 IU/day of human menopausal gonadotrophin (hMG) on days 3, 5 and 7 of the cycle (CC+hMG group, n=29), and 75 IU/day of hMG on days 3 to 8 of the cycle (hMG group, n=57). Statistical analysis was performed using Student's t test to compare the means and the c² test to compare the rates. Results were considered statistically significant at p<0.05. RESULTS: the patients' average age at the onset of the first cycle was 2340 years (mean age, 33.3 years). There were no statistically significant differences between groups. The mean endometrial thickness on the day of the human chorionic gonadotrophin (hCG) administration was significantly higher in the hMG group (10.2±0.2 mm), as compared with the CC and CC+hMG group (7.9±0.4 and 8.7±0.2 mm, respectively, p<0.001). The overall clinical pregnancy rate was 18.2%, and there were no statistically significant differences between the groups (CC group=12.5%; CC+hMG group=24.1% and hMG group=19.3%). CONCLUSION: the results indicate higher mean endometrial thickness in the hMG group as compared with the CC group and the CC+hMG group. There were no significant differences between clinical pregnancy rates obtained with each protocol (CC, CC+hMG and hMG).