Optimal endometrial thickness to maximize live births and minimize pregnancy losses: Analysis of 25,767 fresh embryo transfers
| Autor: | Justin Chu, Madhurima Rajkhowa, Mohammed Khairy, Alison Campbell, Aurelio Tobias, Arri Coomarasamy, Ken Dowell, Simon Fishel, Ioannis D. Gallos |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Fresh embryo medicine.medical_treatment media_common.quotation_subject Fertility Fertilization in Vitro Endometrium 03 medical and health sciences 0302 clinical medicine medicine Humans media_common Pregnancy 030219 obstetrics & reproductive medicine In vitro fertilisation Obstetrics business.industry Obstetrics and Gynecology Embryo Transfer medicine.disease Embryo transfer Abortion Spontaneous 030104 developmental biology Reproductive Medicine Female Live birth business Live Birth Embryo quality Loss rate Developmental Biology |
| Zdroj: | Reproductive BioMedicine Online. 37:542-548 |
| ISSN: | 1472-6483 |
| DOI: | 10.1016/j.rbmo.2018.08.025 |
| Popis: | Research question What is the association of endometrial thickness with pregnancy losses and live births in IVF treatment and the optimal threshold that optimizes the IVF outcome? Design Data were analysed from 25,767 IVF cycles from centres of the CARE Fertility Group in the UK between 2007 and 2016. Transvaginal ultrasound was conducted to measure the maximum endometrial thickness during gonadotrophin stimulation. Live birth rates were per embryo transfer. Pregnancy loss rates included the combination of biochemical and clinical pregnancy losses. Results The live birth rate was 15.6% with 5 mm or less endometrial thickness and gradually increased to 33.1% with an endometrial thickness of 10 mm. On the other hand, the pregnancy loss rate was 41.7% with 5 mm or less endometrial thickness and gradually decreased to 26.5% with an endometrial thickness of 10 mm. Statistical modelling for optimal endometrial thickness threshold found 10 mm or more maximized live births and minimized pregnancy losses. This association was independent after adjusting for confounders such as age, oocyte number, number of transferred embryos, ovarian stimulation protocol and embryo quality for live births (crude RR 1.27; 95% CI 1.21 to 1.33; Adjusted RR 1.18; 95% CI 1.12 to 1.23) and pregnancy losses (crude RR 0.83; 95% CI 0.77 to 0.89; adjusted RR 0.86; 95% CI 0.8 to 0.92). Conclusions Endometrial thickness is strongly associated with pregnancy losses and live births in IVF, and the optimal endometrial thickness threshold of 10 mm or more maximized live births and minimized pregnancy losses. |
| Databáze: | OpenAIRE |
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