Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers

Deng

et al. 2020

Preprint

Background Previous studies have suggested that pregnancy outcome and endometrial thickness before embryo transfer are closely related. However, we found that endometrial thickness changed even within a few days between HCG day and embryo transfer day. There have been few studies on the relationship between endometrial thickness change (ETC) and pregnancy outcomes. The aim of this study was to assess whether the ETC from HCG trigger day to embryo transfer day affects pregnancy outcomes of in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles. Methods This was a retrospective single-center cohort study. In total, 9773 IVF/ICSI embryo transfer cycles involving the long protocol at Chongqing Reproductive and Genetics Institute from January 1st, 2016, to December 30th, 2019, were included. The 9773 cycles were divided into 2 groups based on whether the endometrial thickness decreased from HCG day to embryo transfer day, and clinical pregnancy rates (CPRs) and ongoing pregnancy rates (OPRs) were compared. Logistic regression was used to determine whether an ETC was an independent risk factor for CPR or OPR. Results The CPR and OPR of the decreased endometrial thickness group were higher than those of the non-decreased endometrial thickness group (62.65% and 52.6% vs. 60.56% and 50.18%) (p = 0.041 vs. 0.027). The endometrial thickness change was an independent risk factor for CPR (OR = 0.920, P = 0.003, 95% confidence interval 0.870–0.972) and OPR (OR = 0.907, P = 0.000, 95% confidence interval 0.859–0.958) Conclusions A proper decrease in endometrial thickness from HCG trigger day to embryo transfer day in IVF/ICSI cycles increases the CPR and OPR.

“…ETC was an independent risk factor for CPR and OPR. This conclusion is consistent with that of Jigal Haas's study [3].…”

Section: Discussionsupporting

confidence: 93%

Decreased endometrial thickness between HCG day and embryo transfer day improves the pregnancy rate of IVF/ICSI cycles

Deng

et al. 2020

Preprint

“…Data from this study showed that endometrial thickness in recipients prior to and following progesterone had no impact on pregnancy outcomes. More recently, another cohort study including 271 FET cycles also evaluated endometrial thickness on both the end of the estrogen phase and the day of embryo transfer [14]. Interestingly, they found that a decreased endometrium (endometrial compaction) in response to progesterone results in better pregnancy outcome in FET cycles, which means that the greater the degree of compaction, the higher the ongoing pregnancy rate.…”

Section: Discussionmentioning

confidence: 99%

“…Another point is that the endometrial situation of each patients is re-evaluated on the morning of embryo transfer day also by trans-vaginal ultrasonic examination, which is a more accurate way to measure endometrial thickness. In Haas’s study, endometrial thickness was measured by means by pelvic (transabdominal) ultrasound [14]. This may explain the controversy between the totally opposite results from these two studies.…”

Section: Discussionmentioning

confidence: 99%

The impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst

Yang

Lin

et al. 2019

Reprod Biol Endocrinol

BackgroundThe aim of this study was to explore the impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst.MethodsThis observational cohort study included a total of 3091 patients undergoing their first frozen-thawed embryo transfer (FET) cycles between April 2015 to March 2019. Endometrial thickness was measured by trans-vaginal ultrasound twice for each patient: on day of progesterone administration, and on day of embryo transfer. The change of endometrial thickness was recorded.ResultsRegardless of endometrial preparation protocol (estrogen-progesterone/natural cycle), female age, body mass index (BMI), and infertility diagnosis were comparable between patients with an increasing endometrium on day of embryo transfer and those without. However, clinical pregnancy rate increases with increasing ratio of endometrial thickness. Compared with patients with Non-increase endometrium, those with an increasing endometrium on day of embryo transfer resulted in significantly higher clinical pregnancy rate (56.21% vs 47.13%, P = 0.00 in estrogen-progesterone cycle; 55.15% vs 49.55%, P = 0.00 in natural cycle).ConclusionsIn most patients, endometrial thickness on day of embryo transfer (after progesterone administration) increased or kept being stable compared with that on day of progesterone administration. An increased endometrium after progesterone administration was associated with better pregnancy outcome.

“…In addition, we noted that some recent studies [20,21] that have looked at the effect of endometrial changes between the transfer day and the starting of progesterone day, on clinical pregnancy outcomes. Our results suggest that endometrial compaction on transplantation day has a negative effect on clinical pregnancy outcomes.…”

Section: Plos Onementioning

confidence: 96%

The effect of endometrial thickness on pregnancy outcomes of frozen-thawed embryo transfer cycles which underwent hormone replacement therapy

Zhang

Yin

et al. 2020

PLoS ONE

Objective To investigate the impact of endometrial thickness on the embryo transfer(ET) day on the clinical pregnancy outcomes of frozen-thawed embryo transfer cycles which have undergone hormone replacement therapy(HRT-FET). Methods A total of 10,165 HRT-FET cycles performed between January 2013 to December 2017 in the Reproductive Medicine Center of Henan Provincial People's Hospital were studied retrospectively. All patients were grouped according to their endometrial thickness on the ET day (each group having an increment of 1mm between two neighboring groups). Multivariate regression analysis, curve fitting and threshold effect analysis were performed on all data. Results After adjusting for the age, duration of infertility, body mass index(BMI), infertility type and number and type of embryos transferred, a significant correlation was observed to be between the endometrial thickness and implantation rates (aOR: 1.08; 95% CI: 1.06-1.10, p < 0.0001), clinical pregnancy rate(aOR: 1.10; 95% CI: 1.07-1.14, p < 0.0001)and live birth rate (aOR: 1.09; 95% CI: 1.06-1.12, p < 0.0001). The numerical value of the cutoff point for the endometrial thickness was 8.7 mm. When the endometrial thickness was less than 8.7 mm, with each additional 1 mm of endometrial thickness, the implantation rate increased by 32%, the clinical pregnancy rate increased by 36%, and the live birth rate increased by 45%. Conclusions In the HRT-FET cycles, the optimal live birth rate would be obtained when the endometrial thickness remains within the range of 8.7-14.5 mm. If the endometrium is too thin or too thick, the live birth rate will be reduced.