Predictive value of D‐dimer in patients with unexplained recurrent implantation failure during freeze‐thaw embryo transfer cycles

• Published in: American journal of reproductive immunology (1989) 2023-07, Vol.90 (1), p.e13710-n/a
• Main Authors: Li, Xin, Zeng, Cheng, Wu, Peili, Shang, Jing, Xue, Qing
• Format: Article
• Language: English
• Subjects: Birth; Clinical outcomes; clinical pregnancy rate; D‐dimer; Embryo Implantation; Embryo Transfer; Female; Freeze-thawing; freeze‐thaw embryo transfer; Humans; Implantation; Live Birth; live birth rate; Pregnancy; Pregnancy Rate; Prospective Studies; Retrospective Studies; unexplained recurrent implantation failure
• ISSN: 1046-7408; 1600-0897
• DOI: 10.1111/aji.13710

Background This study aimed to evaluate whether D‐dimer can predict the clinical outcomes of patients with unexplained recurrent implantation failure (URIF) during freeze‐thaw embryo transfer (FET) cycles. Methods Our study was divided into two parts. The first part was a retrospective study that included 433 patients. Plasma D‐dimer levels were monitored in all patients before FET, and the patients were classified into two groups according to whether they delivered at least one live infant or not. D‐dimer was compared between groups, and receiver operating characteristic (ROC) curves were constructed to analyze the impact of D‐dimer on live birth. The second part was a prospective study that included 113 patients who were categorized into high and low D‐dimer groups based on the ROC curve analysis from the retrospective study. Clinical outcomes were compared between these two groups. Results In the first part, we found that plasma D‐dimer levels in patients with live birth were significantly lower than those in patients without live birth. According to the ROC curve, 0.22 mg/L was the cutoff value for D‐dimer in the prediction of the live birth rate (LBR) (AUC 0.806, 95% CI: 0.763, 0.848). The second part of the study confirmed that clinical pregnancy rate (50.98% vs. 32.26%, P = .044) and LBR (41.18% vs. 22.58%, P = .033) of patients with D‐dimer ≤0.22 mg/L were all significantly higher than those of patients with D‐dimer > 0.22 mg/L. Conclusions Our study indicates that D‐dimer > 0.22 mg/L is a useful index for predicting URIF during FET cycles.