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Abstract
Objective
To evaluate the relationship between endometrial thickness measured before embryo transfer, and pregnancy outcomes in frozen-thawed embryo transfer (FET).
Methods
We retrospectively analyzed outcomes of all consecutive FET cycles, from January 2012 to August 2018. Based on ROC analysis for endometrial thickness, we found 8 mm was a reliable cutoff point to predict pregnancy prior to embryo transfer. Accordingly, the cycles were divided into Group A: cycles with endometrial thickness ≤ 8 mm and Group B: > 8 mm.
Results
Group A included 485 FET cycles and group B included 626 cycles. Compared with group A, Group B had significantly higher chemical and clinical pregnancy rates (30.3 vs. 24.6%; p = .046, and 24.0 vs. 18.6%; p = .036), respectively. In multivariate analysis, endometrial thickness and the protocols used were the only parameters influencing the chance to achieve pregnancy, with odds ratio 1.54 (95%CI 1.07–2.22, p = .019) for the endometrium and odds ratio 1.95 (95%CI 1.31–2.9; p = .001) to the protocol used. Endometrial thickness might predict crown-rump length (CRL) discordancy with odds ratio 4.61 (p = .001; 95% CI 1.42–14.92). Compared with group B, Group A had more cases of overt discordancy (13.3 vs. 4%; p = .016).
Conclusions
For patients undergoing FET cycles, endometrial thickness and treatment protocol may predict the chemical and clinical pregnancy rates, as well as CRL discordancy.
Summary
Endometrial thickness and preparation improved pregnancy rate in FET cycles and significantly greater crown-rump length discordancy was observed with thinner endometria.
目的：探讨冻融胚胎移植（FET）前子宫内膜厚度与妊娠结局的关系。
方法：我们回顾性分析了从2012年1月到2018年8月所有连续FET周期的结果。基于子宫内膜厚度的ROC分析, 我们发现8 mm是胚胎移植前预测妊娠的可靠分界点。据此将周期分为A组：子宫内膜厚度≤8 mm的周期和B组：子宫内膜厚度>8 mm的周期。
结果：A组485个FET周期, B组626个周期。与A组相比, B组的生化妊娠率和临床妊娠率均明显高于A组（30.3 vs. 24.6%; p=0.046, 和24.0 vs. 18.6%; p=0.036）。在多变量分析中, 子宫内膜厚度和采用的方案是影响妊娠机会的唯一参数, 子宫内膜的优势比为1.54（95%CI为1.07-2.22, p=0.019）, 采用的方案的优势比为1.95（95%CI为1.31-2.9；p=0.001）。子宫内膜厚度可预测头臀长（CRL）的不一致性, 优势比为4.61（p=0.001；95%CI为1.42-14.92）。与B组相比, A组明显不一致的例数更多（13.3 vs. 4%；p=0.016）。
结论：对于接受FET周期的患者, 子宫内膜厚度和治疗方案可以预测生化妊娠率和临床妊娠率, 以及CRL不一致性。
总结：子宫内膜厚度和准备改善了FET周期的妊娠率, 并且观察到子宫内膜越薄, 头臀长不一致的程度越大。
Acknowledgments
This study was presented in Israeli Fertility Association Conference 2019.
Disclosure statement
All authors report no conflict of interest.
Author contributions
All authors contributed substantially to this study. The authors collectively developed the original study concept. ESP wrote the manuscript. AS and MH revised it critically. Data collection was performed by NA and YA, statistical evaluation by ESP. All authors contributed to critical discussion and reviewed and approved the final version of the manuscript for submission.
Data availability statement
Data will be available upon request.