A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles

Abstract

OBJECTIVE:The objective was to evaluate the relationship between endometrial thickness on the day of human chorionic gonadotropin administration and pregnancy outcome in in vitro fertilization cycles.DESIGN:This was a systematic review and meta-analysis.MATERIALS AND METHODS:We identified 484 articles using Cochrane library, PubMed, Web of Science, and Embase searches with various key words including endometrial thickness, pregnancy, assisted reproductive technology, endometrial pattern, and in vitro fertilization. A total of 14 studies with data on endometrial thickness and outcome were selected, representing 4922 cycles (2204 pregnant and 2718 nonpregnant). The meta-analysis with a random effects model was performed using comprehensive meta-analysis software. We calculated the standardized mean difference, odds ratio (OR), and 95% confidence intervals (CIs).RESULTS:There was a significant difference in the mean endometrial thickness between pregnant and nonpregnant groups (P<0.001), with a standardized mean difference of 0.4 mm (95% CI 0.22–0.58). The OR for pregnancy was 1.40 (95% CI 1.24–1.58).CONCLUSIONS:The mean endometrial thickness was significantly higher in pregnant women compared to nonpregnant. The mean difference between two groups was <1 mm which may not be clinically meaningful. Although there may be a relationship between endometrial thickness and pregnancy, implantation potential is probably more complex than a single ultrasound measurement can determine.

The effects of prognostic factors on pregnancy success among women 39 years or older having intracytoplasmic sperm injection

“…Bazal E 2 değerinin gebelik üzerine etkisinin anlamlı olmadığı ve üç yaş grubu karşılaştırıldığında da anlamlı bir değişim göstermediği kaydedilmiştir (Tablo 2). Yaşla birlikte hormonal değişiklikler endometrium fonksiyonlarını etkilemektedir; böylece endometriumun embriyonun implantasyonunu ve büyümesini destekleme yeteneği de azalmaktadır (22) . Endometrium kalınlığının gebeliğin oluşması ve implantasyon için önemli olduğu bilinmekle birlikte, IVF tedavisine alınan hastalardaki klinik önemi ile ilgili farklı görüşler bildirilmiştir.…”

PI3K, AKT, and P-AKT levels in thin endometrium

“…Previous studies have shown that the endometrium should be 8-14 mm thick for intrauterine implantation of zygotes (Aydin et al, 2013). Therefore, thin endometrium could result in repeated miscarriages or infertility, and in a decreased success rate of assisted reproduction (Momeni et al, 2011). The major features of thin endometrium are high uterine blood flow resistance and delayed growth of glandular epithelium, which could inhibit the expression of vascular endothelial growth factor (VEGF), thereby causing poor growth and development of blood vessels, reducing the perfusion of the endometrium (Miwa et al, 2009).…”

Profound Pituitary Suppression Following Oral Contraceptive Pretreatment in Gonadotropin-releasing Hormone Antagonist Cycles Does Not Impact Outcome: A Retrospective Cohort Study

“…The use of OCP pretreatment has also been associated with a reduction in endometrial thickness compared with no pretreatment, possibly due to the sustained suppression of luteinizing hormone (LH) and estradiol at the start of stimulation [13,14]. Although several studies have suggested a positive association between pregnancy rate and greater endometrial thickness on the day of ovulation trigger, up to a maximum of 12 to 14 mm [15], a reduced endometrial thickness at the start of the cycle may be beneficial in some patients to avoid overly thick endometrium following ovarian stimulation with human menopausal gonadotropin (hMG) [16].…”