The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China
ObjectiveTo investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.MethodsA total of 42,132 fresh cycles between 1 January 2013 and 31 December 2019 were included in this...
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.788706/full |
| _version_ | 1811191552491388928 |
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| author | Jianing Xu Shaodi Zhang Lei Jin Yundong Mao Juanzi Shi Rui Huang Xiao Han Xiaoyan Liang Cuilian Zhang |
| author_facet | Jianing Xu Shaodi Zhang Lei Jin Yundong Mao Juanzi Shi Rui Huang Xiao Han Xiaoyan Liang Cuilian Zhang |
| author_sort | Jianing Xu |
| collection | DOAJ |
| description | ObjectiveTo investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.MethodsA total of 42,132 fresh cycles between 1 January 2013 and 31 December 2019 were included in this retrospective cohort study. Data were collected from five reproductive centers of large academic or university hospitals in China. All patients were divided into different groups according to their endometrial thickness on hCG trigger day. Multivariate regression analysis, curve fitting and threshold effect analysis were performed.ResultsAfter adjusting for age, body mass index, infertility type, number of embryos transferred, number of retrieved oocytes and COS (controlled ovarian stimulation) protocols, significant associations were found between endometrial thickness and clinical pregnancy rate (adjusted odds ratio [aOR]: 1.05; 95% confidence interval [CI]: 1.06–1.08, P < 0.0001), live birth rate (aOR: 1.04; 95% CI: 1.03–1.05, P < 0.0001) as well as miscarriage rate(aOR: 0.96; 95% CI: 0.94 – 0.98, P < 0.0001). When the endometrial thickness was less than 12mm, the clinical pregnancy rate and live birth rate were increased significantly by 10% and 9%(OR:1.10; 95%CI: 1.08-1.12, OR:1.09; 95%CI: 1.07-1.11), respectively, along with the increase of each millimeter increment of endometrial thickness. However, when the EMT ranged from 12-15 mm, were stable at the ideal level, that were not significantly associated with EMT growth. Additionally, clinical pregnancy rate and live birth rate were slightly reduced by 6% and 4% when EMT was ≥15mm. Meanwhile, the miscarriage rate was significantly declined by 8% (OR:0.92; 95%CI: 0.90-0.95)with each millimeter increment of EMT. And when EMT was thicker than 12mm, the miscarriage rate didn’t change any more significantly.ConclusionsEndometrial thickness exhibits a curvilinear relationship with pregnancy outcomes in fresh embryo transfer cycles. Clinical pregnancy rate, live birth rate and miscarriage rate may achieve their optimal level when EMT ≥ 12 mm, but some adverse pregnancy outcomes would be observed when EMT ≥15 mm especially for clinical pregnancy. |
| first_indexed | 2024-04-11T18:12:55Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-11T18:12:55Z |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-69db06f600e5439fba1e5adfb6ba63522022-12-22T04:10:03ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922022-01-011210.3389/fendo.2021.788706788706The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in ChinaJianing Xu0Shaodi Zhang1Lei Jin2Yundong Mao3Juanzi Shi4Rui Huang5Xiao Han6Xiaoyan Liang7Cuilian Zhang8Reproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, ChinaReproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, ChinaReproductive Medicine Center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, ChinaReproductive Medicine Center, Jiangsu Provincial Hospital, Nanjing, ChinaReproductive Medicine Center, Northwest Women’s and Children’s Hospital, Xi’an, ChinaReproductive Medicine Center, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaReproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, ChinaReproductive Medicine Center, Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, ChinaReproductive Medicine Center, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, ChinaObjectiveTo investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.MethodsA total of 42,132 fresh cycles between 1 January 2013 and 31 December 2019 were included in this retrospective cohort study. Data were collected from five reproductive centers of large academic or university hospitals in China. All patients were divided into different groups according to their endometrial thickness on hCG trigger day. Multivariate regression analysis, curve fitting and threshold effect analysis were performed.ResultsAfter adjusting for age, body mass index, infertility type, number of embryos transferred, number of retrieved oocytes and COS (controlled ovarian stimulation) protocols, significant associations were found between endometrial thickness and clinical pregnancy rate (adjusted odds ratio [aOR]: 1.05; 95% confidence interval [CI]: 1.06–1.08, P < 0.0001), live birth rate (aOR: 1.04; 95% CI: 1.03–1.05, P < 0.0001) as well as miscarriage rate(aOR: 0.96; 95% CI: 0.94 – 0.98, P < 0.0001). When the endometrial thickness was less than 12mm, the clinical pregnancy rate and live birth rate were increased significantly by 10% and 9%(OR:1.10; 95%CI: 1.08-1.12, OR:1.09; 95%CI: 1.07-1.11), respectively, along with the increase of each millimeter increment of endometrial thickness. However, when the EMT ranged from 12-15 mm, were stable at the ideal level, that were not significantly associated with EMT growth. Additionally, clinical pregnancy rate and live birth rate were slightly reduced by 6% and 4% when EMT was ≥15mm. Meanwhile, the miscarriage rate was significantly declined by 8% (OR:0.92; 95%CI: 0.90-0.95)with each millimeter increment of EMT. And when EMT was thicker than 12mm, the miscarriage rate didn’t change any more significantly.ConclusionsEndometrial thickness exhibits a curvilinear relationship with pregnancy outcomes in fresh embryo transfer cycles. Clinical pregnancy rate, live birth rate and miscarriage rate may achieve their optimal level when EMT ≥ 12 mm, but some adverse pregnancy outcomes would be observed when EMT ≥15 mm especially for clinical pregnancy.https://www.frontiersin.org/articles/10.3389/fendo.2021.788706/fullIVF/ICSIclinical pregnancy rateendometrial thicknesslive birth rate (LBR)fresh embryo transfer (fresh ET) |
| spellingShingle | Jianing Xu Shaodi Zhang Lei Jin Yundong Mao Juanzi Shi Rui Huang Xiao Han Xiaoyan Liang Cuilian Zhang The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China Frontiers in Endocrinology IVF/ICSI clinical pregnancy rate endometrial thickness live birth rate (LBR) fresh embryo transfer (fresh ET) |
| title | The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China |
| title_full | The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China |
| title_fullStr | The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China |
| title_full_unstemmed | The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China |
| title_short | The Effects of Endometrial Thickness on Pregnancy Outcomes of Fresh IVF/ICSI Embryo Transfer Cycles: An Analysis of Over 40,000 Cycles Among Five Reproductive Centers in China |
| title_sort | effects of endometrial thickness on pregnancy outcomes of fresh ivf icsi embryo transfer cycles an analysis of over 40 000 cycles among five reproductive centers in china |
| topic | IVF/ICSI clinical pregnancy rate endometrial thickness live birth rate (LBR) fresh embryo transfer (fresh ET) |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.788706/full |
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