Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers

Abstract

Objective To evaluate the relation of endometrial thickness (EnT) and endometrial pattern (EnP) to euploid embryo transfer (ET) outcomes. Design Retrospective cohort Setting Private academic clinic Patients Patients (n=277, 36.1±4.0 years) whose embryos (n=476) underwent aneuploidy screening with fresh (n=176) or frozen (n=180) ET from July 2010–March 2014. Interventions EnT and EnP were measured on trigger day and at ET. Patients were stratified by age and cycle type (fresh or frozen). Cycle data were combined at trigger day but separated at ET day. Main Outcome Measures Outcome measures were implantation (IR), pregnancy (PR) and clinical pregnancy (CPR) rates. Analysis was conducted by chi-square and Fisher exact test with significance at p<0.05. Results 234 gestational sacs, 251 pregnancies and 202 clinical pregnancies resulted from 356 cycles. EnT (9.6±1.8mm; range 5–15mm) at trigger day (n=241 cycles) as a continuous or categorical (≤8 vs >8mm) variable was not associated with IR, PR or CPR. EnT at day of fresh (9.7±2.2mm; range 4.4–17.9mm) (n=176 cycles) or frozen ET (9.1±2.1mm; range 4.2–17.7mm) (n=180 cycles) was not associated with IR, PR or CPR. Type 3 EnP at trigger day was associated with increased serum progesterone at trigger and decreased IR compared with type 2 EnP. EnP at fresh or frozen ET was not associated with IR, PR or CPR. Conclusions Within the study population, EnT was not significantly associated with clinical outcomes of euploid ETs. A type 3 EnP at trigger day suggests a prematurely closed window of implantation.

Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis

“…In a retrospective observational study, an endometrial thickness of 9-14 mm on the day of progesterone supplementation was associated with significantly higher implantation and pregnancy rates compared with an endometrial thickness of 7-8 mm [73]. However, neither endometrial thickness nor endometrial pattern had any impact on implantation and pregnancy rates following euploid blastocyst transfer [74].…”

The endometrial preparation for frozen-thawed euploid blastocyst transfer: a prospective randomized trial comparing clinical results from natural modified cycle and exogenous hormone stimulation with GnRH agonist

“…Some studies have documented that the endometrial thickness was not associated with implantation and clinical pregnancy rates on the day of fresh and frozen embryo transfer [58]. However, the study by Zhao et al [59] suggested that pregnancy was unlikely to occur when the endometrial thickness was <6 mm.…”

Estrogen supplementation in art (a review)

“…[57] изучали влияние толщины и структуры эндометрия на исхо-ды переносов свежих и размороженных эуплоидных эмбрионов после преимплантационной генетиче-ской диагностики. Авторы не выявили зависимости между частотой имплантации, частотой наступления клинической беременности и толщиной эндометрия в день переноса эмбрионов.…”