Endometrial thickness measurements among Asherman syndrome patients prior to embryo transfer
| Autor: | B. Morales, Joyce Wang, Jennifer Wang, Peter Movilla, S.N. Morris, T.Y. Chen, A. Williams, M. Loring, Himabindu Reddy, Keith B. Isaacson, J. Tavcar |
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| Rok vydání: | 2020 |
| Předmět: |
Infertility
medicine.medical_specialty Pregnancy Rate Fertilization in Vitro Gynatresia Disease Endometrium 03 medical and health sciences 0302 clinical medicine Pregnancy medicine Humans Retrospective Studies 030304 developmental biology 0303 health sciences 030219 obstetrics & reproductive medicine Obstetrics business.industry Rehabilitation Obstetrics and Gynecology Retrospective cohort study Odds ratio Embryo Transfer medicine.disease Embryo transfer medicine.anatomical_structure Reproductive Medicine Asherman Syndrome Cohort Female business |
| Zdroj: | Human Reproduction. 35:2746-2754 |
| ISSN: | 1460-2350 0268-1161 |
| DOI: | 10.1093/humrep/deaa273 |
| Popis: | STUDY QUESTION Is there an association between endometrial thickness (EMT) measurement and clinical pregnancy rate among Asherman syndrome (AS) patients utilizing IVF and embryo transfer (ET)? SUMMARY ANSWER EMT measurements may not be associated with successful clinical pregnancy among AS patients undergoing IVF. WHAT IS KNOWN ALREADY Clinical pregnancy rate after IVF is significantly lower in patients with a thin endometrium, defined as a maximum EMT of STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study of 45 AS patients treated at a specialized advanced hysteroscopic clinic from 1 January 2015, to 1 March 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS Review of EMT measurements prior to a total of 90 ETs, among 45 AS patients. The impact of the maximum EMT measurement prior to ET on clinical pregnancy rate was analyzed. MAIN RESULTS AND THE ROLE OF CHANCE A total of 25/45 (55.6%) AS patients ultimately went on to have ≥1 clinical pregnancy following a mean ± SD of 2.00 ± 1.26 ET attempts. There was a total of 90 ETs among the 45 AS patients, with 29/90 (32.2%) ETs resulting in a clinical pregnancy. Younger patient age (P = 0.05) and oocyte donation (P = 0.01) were the only variables identified to be significant predictors for a positive clinical pregnancy outcome on bivariate analysis. The mean EMT measurement prior to all ETs among AS patients was 7.5 ± 1.6 mm. EMT measurement prior to ET did not predict a positive clinical pregnancy on either bivariate (P = 0.84) or multivariable analysis (odds ratio 0.91, P = 0.60). 31.8% of EMT measurements measured LIMITATIONS, REASONS FOR CAUTION Our small sample size limits our ability to draw any definitive conclusions. In addition, patients utilized various infertility clinics. This limits our ability to evaluate the consistency of EMT measurements and the IVF care that was received. WIDER IMPLICATIONS OF THE FINDINGS EMT measurement cutoff values should be used with caution if canceling a scheduled ET in AS patients. STUDY FUNDING/COMPETING INTEREST(S) This study was not funded. K.I. reports personal fees from Karl Stroz and personal fees from Medtronics outside the submitted work. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. |
| Databáze: | OpenAIRE |
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