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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
To investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles. A total of 42,132 fresh cycles between 1 January 2013 and 31 December 2019 were included in this retrospective cohort st...
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Published in: | Frontiers in endocrinology (Lausanne) 2022-01, Vol.12, p.788706-788706 |
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description | To investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh
fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
A 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.
After 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.
Endometrial 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. |
doi_str_mv | 10.3389/fendo.2021.788706 |
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fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
A 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.
After 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.
Endometrial 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.</description><identifier>ISSN: 1664-2392</identifier><identifier>EISSN: 1664-2392</identifier><identifier>DOI: 10.3389/fendo.2021.788706</identifier><identifier>PMID: 35140680</identifier><language>eng</language><publisher>Switzerland: Frontiers Media S.A</publisher><subject>Adult ; China ; clinical pregnancy rate ; Embryo Transfer - methods ; Endocrinology ; endometrial thickness ; Endometrium - anatomy & histology ; Endometrium - diagnostic imaging ; Female ; Fertilization in Vitro - methods ; fresh embryo transfer (fresh ET) ; Humans ; IVF/ICSI ; live birth rate (LBR) ; Organ Size ; Pregnancy ; Pregnancy Outcome - epidemiology ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic - methods</subject><ispartof>Frontiers in endocrinology (Lausanne), 2022-01, Vol.12, p.788706-788706</ispartof><rights>Copyright © 2022 Xu, Zhang, Jin, Mao, Shi, Huang, Han, Liang and Zhang.</rights><rights>Copyright © 2022 Xu, Zhang, Jin, Mao, Shi, Huang, Han, Liang and Zhang 2022 Xu, Zhang, Jin, Mao, Shi, Huang, Han, Liang and Zhang</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c531t-5fc4b7fb110256703e08dfa1b2d96b9df53a813678b7ae1acdb648458611f6053</citedby><cites>FETCH-LOGICAL-c531t-5fc4b7fb110256703e08dfa1b2d96b9df53a813678b7ae1acdb648458611f6053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818785/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8818785/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35140680$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xu, Jianing</creatorcontrib><creatorcontrib>Zhang, Shaodi</creatorcontrib><creatorcontrib>Jin, Lei</creatorcontrib><creatorcontrib>Mao, Yundong</creatorcontrib><creatorcontrib>Shi, Juanzi</creatorcontrib><creatorcontrib>Huang, Rui</creatorcontrib><creatorcontrib>Han, Xiao</creatorcontrib><creatorcontrib>Liang, Xiaoyan</creatorcontrib><creatorcontrib>Zhang, Cuilian</creatorcontrib><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><title>Frontiers in endocrinology (Lausanne)</title><addtitle>Front Endocrinol (Lausanne)</addtitle><description>To investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh
fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
A 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.
After 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.
Endometrial 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.</description><subject>Adult</subject><subject>China</subject><subject>clinical pregnancy rate</subject><subject>Embryo Transfer - methods</subject><subject>Endocrinology</subject><subject>endometrial thickness</subject><subject>Endometrium - anatomy & histology</subject><subject>Endometrium - diagnostic imaging</subject><subject>Female</subject><subject>Fertilization in Vitro - methods</subject><subject>fresh embryo transfer (fresh ET)</subject><subject>Humans</subject><subject>IVF/ICSI</subject><subject>live birth rate (LBR)</subject><subject>Organ Size</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Pregnancy Rate</subject><subject>Sperm Injections, Intracytoplasmic - methods</subject><issn>1664-2392</issn><issn>1664-2392</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVUttq2zAYNmNjLV0fYDdDl7tYUsmyZXkXg2CSzVDI2LLdCkn-laizpUxyAnmqvuKUw0orBDp8B32CL8veEzyllNd3BlznpznOybTivMLsVXZNGCsmOa3z18_2V9ltjA84jQKTuuZvsytakgIzjq-zx9UG0NwY0GNE3qB5Mh1gDFb2aLWx-o-DmACHvgdYO-n0AS13o06cE30RIG5Q-3tx1zY_WzQfVDh4tArSRQMBNQfdQ_yMZi5N2R-iPamW-4QV-FOKdKGg2eDdGi3sHtAP2Abf7fR4PDTgRggRWYeajXXyXfbGyD7C7WW9yX4t5qvm2-R--bVtZvcTXVIyTkqjC1UZRQjOS1ZhCph3RhKVdzVTdWdKKjmhrOKqkkCk7hQreFFyRohhuKQ3WXv27bx8ENtgBxkOwksrThc-rIUMo03ZBas7hVlSYSgLWhslCZSyM4opyWiZJ68vZ6_tTg3Q6fSlIPsXpi8RZzdi7feCc8Irfgzz8WIQ_N8dxFEMNmroe-nA76LIWV4VVUUxS1RypurgYwxgnp4hWBx7I069EcfeiHNvkubD83xPiv8tof8ANznAGw</recordid><startdate>20220124</startdate><enddate>20220124</enddate><creator>Xu, Jianing</creator><creator>Zhang, Shaodi</creator><creator>Jin, Lei</creator><creator>Mao, Yundong</creator><creator>Shi, Juanzi</creator><creator>Huang, Rui</creator><creator>Han, Xiao</creator><creator>Liang, Xiaoyan</creator><creator>Zhang, Cuilian</creator><general>Frontiers Media S.A</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20220124</creationdate><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><author>Xu, Jianing ; Zhang, Shaodi ; Jin, Lei ; Mao, Yundong ; Shi, Juanzi ; Huang, Rui ; Han, Xiao ; Liang, Xiaoyan ; Zhang, Cuilian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c531t-5fc4b7fb110256703e08dfa1b2d96b9df53a813678b7ae1acdb648458611f6053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Adult</topic><topic>China</topic><topic>clinical pregnancy rate</topic><topic>Embryo Transfer - methods</topic><topic>Endocrinology</topic><topic>endometrial thickness</topic><topic>Endometrium - anatomy & histology</topic><topic>Endometrium - diagnostic imaging</topic><topic>Female</topic><topic>Fertilization in Vitro - methods</topic><topic>fresh embryo transfer (fresh ET)</topic><topic>Humans</topic><topic>IVF/ICSI</topic><topic>live birth rate (LBR)</topic><topic>Organ Size</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome - epidemiology</topic><topic>Pregnancy Rate</topic><topic>Sperm Injections, Intracytoplasmic - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xu, Jianing</creatorcontrib><creatorcontrib>Zhang, Shaodi</creatorcontrib><creatorcontrib>Jin, Lei</creatorcontrib><creatorcontrib>Mao, Yundong</creatorcontrib><creatorcontrib>Shi, Juanzi</creatorcontrib><creatorcontrib>Huang, Rui</creatorcontrib><creatorcontrib>Han, Xiao</creatorcontrib><creatorcontrib>Liang, Xiaoyan</creatorcontrib><creatorcontrib>Zhang, Cuilian</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>Directory of Open Access Journals</collection><jtitle>Frontiers in endocrinology (Lausanne)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Jianing</au><au>Zhang, Shaodi</au><au>Jin, Lei</au><au>Mao, Yundong</au><au>Shi, Juanzi</au><au>Huang, Rui</au><au>Han, Xiao</au><au>Liang, Xiaoyan</au><au>Zhang, Cuilian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Frontiers in endocrinology (Lausanne)</jtitle><addtitle>Front Endocrinol (Lausanne)</addtitle><date>2022-01-24</date><risdate>2022</risdate><volume>12</volume><spage>788706</spage><epage>788706</epage><pages>788706-788706</pages><issn>1664-2392</issn><eissn>1664-2392</eissn><abstract>To investigate the effects of endometrial thickness (EMT) on pregnancy outcomes on hCG trigger day in fresh
fertilization (IVF) and intracytoplasmic sperm injection (ICSI) cycles.
A 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.
After 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.
Endometrial 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.</abstract><cop>Switzerland</cop><pub>Frontiers Media S.A</pub><pmid>35140680</pmid><doi>10.3389/fendo.2021.788706</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult China clinical pregnancy rate Embryo Transfer - methods Endocrinology endometrial thickness Endometrium - anatomy & histology Endometrium - diagnostic imaging Female Fertilization in Vitro - methods fresh embryo transfer (fresh ET) Humans IVF/ICSI live birth rate (LBR) Organ Size Pregnancy Pregnancy Outcome - epidemiology Pregnancy Rate Sperm Injections, Intracytoplasmic - methods |
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 |
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