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

Zhang, Shaodi; Li, Qiuyuan; Yin, Yue; Zhang, Cuilian

doi:10.1371/journal.pone.0239120

Cited by 38 publications

(18 citation statements)

References 22 publications

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“…Thought these studies were differed in the type of US used (TA vs TV), but all were retrospective & utilized blastocyst embryos where the decreased EMT still suitable for a good clinical outcome as blastocyst implant shortly after transfer. However, this was not ideal for cleavage embryo as stated by (Shaodi et al, 2020) who performed a large retrospective analysis of 10,165 HRT-FET cycles of cleavage stage embryos using TV-US for EMT measurement, they found that endometrial compaction on embryo transfer day has a negative consequence on pregnancy outcomes whereas the EMT cut-off value of 8.7 mm & interval of (8.7-14.5 mm) were correlated better with clinical outcomes than the delta of EMT before & after P administration, that's thin <7mm or thick >14.5mm EMT might lowered Live birth rate (LBR).…”

Section: Resultsmentioning

confidence: 99%

Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

Jarrah¹,

Al-Obaidi²,

Asadi³

2021

ijrps

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Endometrial receptivity plays a basic role in successful embryo implantation and pregnancy outcomes and can be assessed by many of non-invasive markers. Our study evaluated the impact of two of these markers specifically serum progesterone and endometrial thickness at embryo transfer day in prediction pregnancy outcomes on (60) patients attempting medicated frozen embryo transfer (FET) cycles. All patients were received sequential estrogen & progesterone medications for endometrial preparation then submitted to measurements of endometrial thickness (EMT) by transvaginal-ultrasound (TV-US) & serums progesterone (P) analysis at the embryo transfer day, thereafter day 3 verified-thawed embryos grades (A±B) were transferred. Compacted (decreased) EMT was seen in 48.3% of patients with higher pregnancy rate (PR) of 58.6%t than non-compacted EMT (no change or increased) which was seen in 51.7% of patients with (PR) of 29.0%, (P value=0.021). However ongoing pregnancy rate (Ong PR) not differed significantly between both groups (44.8% in compacted vs 25.8% in non-compacted, P value=0.053), also the means of serum P not differed between pregnant and non-pregnant patients (P value=0.374). ROC curves for Ong PR prediction in relations to endometrial compaction & serum progesterone at embryo transfer day were poor (AUC= 0.630, & AUC=0.576, respectively). This study suggested that endometrial compaction or serum P levels measurements at embryo transfer day were poor predictors for ongoing pregnancy where any kind of EMT changes (decreased or not) seen after P administration not significantly affect pregnancy outcomes in frozen-thaw cycles of cleavage stage embryos transfer.

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Section: Resultsmentioning

confidence: 99%

Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

Jarrah¹,

Al-Obaidi²,

Asadi³

2021

ijrps

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“…A clinical study confirmed that endometrial thickness could be used to predict endometrial receptivity [67]. Zhang et al [68] reported in a retrospective study that the highest rate of live births occurred when the endometrial thickness was at 8.7-14.5 mm, and endometrial thickness would affect implantation rate, pregnancy rate and live birth rate. We found that PPCNg/hAMSCs contributed to thicker endometrium and more epithelial cells.…”

Section: Discussionmentioning

confidence: 97%

Human amniotic mesenchymal stem cells combined with PPCNg facilitate injured endometrial regeneration

Huang

Zhang

et al. 2022

Stem Cell Res Ther

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Background Caused by the injury to the endometrial basal layer, intrauterine adhesions (IUA) are characterized by uterine cavity obliteration, leading to impaired fertility. Human amniotic mesenchymal stem cells (hAMSCs) have the potential to promote endometrial regeneration mainly through paracrine ability. PPCNg is a thermoresponsive biomaterial consisted of Poly (polyethylene glycol citrate-co-N-isopropylacrylamide) (PPCN) mixed with gelatin, which has been reported as a scaffold for stem cell transplantation. This study aims to investigate the therapeutic effect of hAMSCs combined with PPCNg transplantation in promoting the regeneration of injured endometrium. Methods hAMSCs were cultured in different concentrates of PPCNg in vitro, and their proliferation, apoptosis and cell cycle were examined by CCK-8 assay and flow cytometry. Immunofluorescence was used to determine the MSCs specific surface markers. The expression of pluripotent genes was analyzed by qRT-PCR. The multiple-lineage differentiation potential was further evaluated by detecting the differentiation-related genes using qRT-PCR and specific staining. The Sprague–Dawley (SD) rat IUA model was established with 95% ethanol. hAMSCs combined with PPCNg were transplanted through intrauterine injection. The retention of DiR-labeled hAMSCs was observed by vivo fluorescence imaging. The endometrium morphology was assessed using hematoxylin and eosin (H&E) and Masson staining. Immunohistochemistry staining was performed to detect biomarkers related to endometrial proliferation, re-epithelialization, angiogenesis and endometrial receptivity. The function of regenerated endometrium was evaluated by pregnancy tests. Results hAMSCs maintained normal cell proliferation, apoptosis and cell cycle in PPCNg. Immunofluorescence and qRT-PCR showed that hAMSCs cultured in PPCNg and hAMSCs cultured alone expressed the same surface markers and pluripotent genes. hAMSCs exhibited normal multilineage differentiation potential in PPCNg. Vivo fluorescence imaging results revealed that the fluorescence intensity of hAMSCs combined with PPCNg intrauterine transplantation was stronger than that of direct hAMSCs intrauterine transplantation. Histological assays showed the increase in the thickness of endometrial and the number of endometrial glands, and the remarkably decrease in the fibrosis area in the PPCNg/hAMSCs group. The expressions of Ki-67, CK7, CK19, VEGF, ER and PR were significantly increased in the PPCNg/hAMSCs group. Moreover, the number of implanted embryos and pregnancy rate were significantly higher in the PPCNg/hAMSCs group than in the hAMSCs group. Conclusions PPCNg is suitable for growth, phenotype maintenance and multilineage differentiation of hAMSCs. hAMSCs combined with PPCNg intrauterine transplantation can facilitate the regeneration of injured endometrium by improving utilization rates of hAMSCs, and eventually restore reproductive capacity.

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“…Two retrospective cohort studies also showed that the endometrial thickness was less in the HRT group than in the NC group (29,30).However, there was no statistical difference in the incidence of biochemical pregnancy, clinical pregnancy, miscarriage or live birth between the two groups(30), probably because endometrial thickness is not a decisive parameter for successful pregnancy (31). However, a study by Shaodi et al (2020) showed that to obtain optimal live birth rate, the endometrial thickness must remain within the range of 8.7-14.5mm as too thin or too thick endometrium would reduce the live birth live (32) .More studies are needed to address the effect of endometrial thickness on pregnancy outcome.…”

Section: Discussionmentioning

confidence: 99%

Effect of different endometrial preparation protocols on pregnancy outcomes in frozen- embryo transfer cycles: a retrospective cohort study

Qian

Wan

et al. 2021

Preprint

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Background Owing to the crucial role the endometrium plays in embryo implantation, the four main endometrial preparation protocols have become important factors in the study of pregnancy outcomes in the FET cycles. Previous studies have shown that the best of these four protocols remains controversial for women undergoing FET. Methods A total of 10333 FET cycles from January 2018 to December 2018 were analyzed in this study. They were categorized into four groups according to endometrial preparation regimen: natural cycles (Group NC,n = 815), hormone replacement therapy cycles (Group HRT ,n = 6434), GnRH agonist artificial cycles (Group GAC,n = 1392) and ovarian stimulation cycles (Group OC, n = 1692). All patients were followed up for at least 1 year. Pregnancy outcomes were compared between the four groups and multiple logistic regression models were used to adjust for the effects of confounding factors. Results The ectopic pregnancy rate (P = 0.627) and miscarriage rate (P = 0.164) were not statistically significant between the four groups. Moreover, biochemical pregnancy rate, clinical pregnancy rate and live birth rate in the NC group were not statistically significant compared to the other three groups. After adjusting for covariates, multiple logistic regression analysis showed no statistical significance in pregnancy outcomes in the HRT, GAC and OC groups compared to the NC group.And the adjusted OR for live births was 0.988 (95 % CI0.847-1.152) for the HRT group, 0.955 (95 % CI0.795-1.146) for the GAC group,0.898 (95 % CI0.754-1.070) for the OC group. Conclusions Our study showed that natural cycles have similar pregnancy outcomes in terms of clinical pregnancy and live birth to the other three endometrial preparation options. As it has other advantages, the natural cycle protocol can therefore be the recommended option for endometrial preparation in the FET population.

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

Cited by 38 publications

References 22 publications

Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

Human amniotic mesenchymal stem cells combined with PPCNg facilitate injured endometrial regeneration

Effect of different endometrial preparation protocols on pregnancy outcomes in frozen- embryo transfer cycles: a retrospective cohort study

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