Uterine length and fertility outcomes: a cohort study in the IVF population

Hawkins, L.K.; Correia, Katharine F.; Srouji, Serene S.; Hornstein, Mark D.; Missmer, S.A.

doi:10.1093/humrep/det344

Cited by 19 publications

(11 citation statements)

References 25 publications

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“…Previous studies have supported that abnormal development of the corpus uteri impacted the development of cervix uteri [23]. A prospective study by Hawkins et al revealed that women with uterine lengths (defined as the distance from the external cervical os to the uterine fundus) shorter than 6 cm were more likely to experience spontaneous abortions [24]. Collectively, the use of uterine length as a significant determinant factor in pre-pregnancy examinations should never be ignored.…”

Section: Discussionmentioning

confidence: 99%

Development and validation of a model for individualized prediction of cervical insufficiency risks in patients undergoing IVF/ICSI treatment

Wu¹,

Liang²,

Cai³

et al. 2021

Reprod Biol Endocrinol

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Background Women who conceived with in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) are more likely to experience adverse pregnancy outcomes than women who conceived naturally. Cervical insufficiency (CI) is one of the important causes of miscarriage and premature birth, however there is no published data available focusing on the potential risk factors predicting CI occurrence in women who received IVF/ICSI treatment. This study aimed to identify the risk factors that could be integrated into a predictive model for CI, which could provide further personalized and clinically specific information related to the incidence of CI after IVF/ICSI treatment. Patients and methods This retrospective study included 4710 patients who conceived after IVF/ICSI treatment from Jan 2011 to Dec 2018 at a public university hospital. The patients were randomly divided into development (n = 3108) and validation (n = 1602) samples for the building and testing of the nomogram, respectively. Multivariate logistic regression was developed on the basis of pre-pregnancy clinical covariates assessed for their association with CI occurrence. Results A total of 109 patients (2.31%) experienced CI among all the enrolled patients. Body mass index (BMI), basal serum testosterone (T), gravidity and uterine length were associated with CI occurrence. The statistical nomogram was built based on BMI, serum T, gravidity and uterine length, with an area under the curve (AUC) of 0.84 (95% confidence interval: 0.76–0.90) for the developing cohort. The AUC for the validation cohort was 0.71 (95% confidence interval: 0.69–0.83), showing a satisfactory goodness-of-fit and discrimination ability in this nomogram. Conclusion The user-friendly nomogram which graphically represents the risk factors and a pre-pregnancy predicted tool for the incidence of CI in patients undergoing IVF/ICSI treatment, provides a useful guide for medical staff on individualized decisions making, where preventive measures could be carried out during the IVF/ICSI procedure and subsequent pregnancy.

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Section: Discussionmentioning

confidence: 99%

Development and validation of a model for individualized prediction of cervical insufficiency risks in patients undergoing IVF/ICSI treatment

Wu¹,

Liang²,

Cai³

et al. 2021

Reprod Biol Endocrinol

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“…Recently, a retrospective study from Li et al demonstrated that adenomyosis patients with a larger uterine volume suffered from lower live birth rate due to a higher incidence of miscarriage ( 9 ). A prospective study by Hawkins et al also revealed that women with uterine lengths longer than 9 cm were more likely to experience spontaneous abortions ( 24 ). Consistently, a uterine volume larger than 102.02 cm 3 was associated with a lower live birth rate in our study.…”

Section: Discussionmentioning

confidence: 99%

A Validated Model for Individualized Prediction of Live Birth in Patients With Adenomyosis Undergoing Frozen–Thawed Embryo Transfer

Rong

Lin

et al. 2022

Front. Endocrinol.

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PurposeThis study aimed to develop a predictive tool for live birth in women with adenomyosis undergoing in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) treatment.MethodsA total of 424 patients with adenomyosis who underwent frozen–thawed embryo transfer (FET) from January 2013 to December 2019 at a public university hospital were included. The patients were randomly divided into training (n = 265) and validation (n = 159) samples for the building and testing of the nomogram, respectively. Multivariate logistic regression (MLR) was developed on the basis of clinical covariates assessed for their association with live birth.ResultsIn total, 183 (43.16%) patients became pregnant, and 114 (26.88%) had a live birth. The MLR showed that the probability of live birth was significantly correlated with age [odds ratio (OR), 3.465; 95% confidence interval (CI), 1.215–9.885, P = 0.020], uterine volume (OR, 8.141; 95% CI, 2.170–10.542; P = 0.002), blastocyst transfer (OR, 3.231; 95% CI, 1.065–8.819, P = 0.023), twin pregnancy (OR, 0.328; 95% CI, 0.104–0.344, P = 0.005), and protocol in FET (P < 0.001). The statistical nomogram was built based on age, uterine volume, twin pregnancy, stage of the transferred embryo, and protocol of FET, with an area under the curve (AUC) of 0.837 (95% CI: 0.741–0.910) for the training cohort. The AUC for the validation cohort was 0.737 (95% CI: 0.661–0.813), presenting a well-pleasing goodness-of-fit and stability in this model.ConclusionsThis visual and easily applied nomogram built on the risk factors of live birth in patients with adenomyosis provides useful and precise information for physicians on individualized decision-making during the IVF/ICSI procedure.

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“…23 Excess estrogen in obesity may alter uterine size, receptivity, or ovarian signaling to increase loss. 9,24,25 A statistically significant relationship was observed between black ethnicity and second-trimester loss. However, the sample size was very small (n548) such that concerns for residual confounding by leiomyomas, obesity, and other known risk factors for loss cannot be ruled out.…”

Section: Discussionmentioning

confidence: 96%

Factors Associated With Second-Trimester Pregnancy Loss in Women With Normal Uterine Anatomy Undergoing In Vitro Fertilization

Bressler

Correia

Srouji

et al. 2015

Obstetrics &Amp; Gynecology

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Uterine length and fertility outcomes: a cohort study in the IVF population

Abstract: No funding was sought for this investigation. MD declares relationships with UpToDate (royalties) and WINFertlity (consultant).

Cited by 19 publications

References 25 publications

Development and validation of a model for individualized prediction of cervical insufficiency risks in patients undergoing IVF/ICSI treatment

Development and validation of a model for individualized prediction of cervical insufficiency risks in patients undergoing IVF/ICSI treatment

A Validated Model for Individualized Prediction of Live Birth in Patients With Adenomyosis Undergoing Frozen–Thawed Embryo Transfer

Factors Associated With Second-Trimester Pregnancy Loss in Women With Normal Uterine Anatomy Undergoing In Vitro Fertilization

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