Objective To assess whether the subendometrial blood flow condition
detected by Doppler ultrasound could predict pregnancy outcomes in
patients with thin endometrium during in vitro fertilization (IVF)
treatment. Design Retrospective cohort study. Setting Reproductive
Hospital affiliated with Shandong University, Jinan, Shandong, China
Population or Sample The study included 3830 frozen embryo transfer
(FET) cycles of 3,830 IVF patients between January 2017 to December
2019. Methods Endometrial thickness, endometrial blood flow, and
subendometrial blood flow were measured using transvaginal color Doppler
ultrasound, evaluated by experienced clinical ultrasound physicians on
the day of endometrial transformation. Logistic binary regression was
used to analyze the effects of subendometrial blood flow on successful
embryo implantation. Pregnancy outcomes of these patients were
documented in clinic medical records during follow-up. Main Outcome
Measures Pregnancy outcomes (biochemical pregnancy rate, clinical
pregnancy rate and live birth rate) Results A total of 3830 frozen
embryo transfer cycles were retrospectively analyzed. Our results show
that patients with subendometrial blood flow exhibit higher average
success rates of live birth, clinical pregnancy, and embryo implantation
compared to those without subendometrial blood flow when endometrial
thickness is ≤ 0.7 cm. In detail, in thin endometrium patient group, the
presence of subendometrial blood flow is correlated with 7.2% higher
biochemical pregnancy rate, 7.0% higher clinical pregnancy rate, and
6.2% higher live birth rate compared to those without subendometrial
blood flow. Conclusions Endometrial and subendometrial blood flow
conditions have predictive value for pregnancy outcomes after frozen
embryo transfer in patients with thin endometrium
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