Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers

Abstract

Objective: To evaluate whether the change in endometrial thickness between the end of the estrogen phase and the day of embryo transfer has an impact on the pregnancy rate in frozen-thawed embryo transfer (FET) cycles. Design: Retrospective observational cohort study. Setting: Single tertiary care medical center. Patient(s): Ultrasound images in 274 FET cycles were reviewed. All patients underwent endometrial preparation with the use of hormonal therapy. Interventions(s): Ultrasound measurements of endometrial thickness at the end of the estrogen phase and the day of embryo transfer. Main Outcome Measure(s): The change in endometrial thickness and ongoing pregnancy rate. Result(s): We calculated the ongoing pregnancy rate in patients whose endometrial thickness decreased (compacted) after starting progesterone by 5%, 10%, 15%, or 20% compared with patients with no change or increased endometrial thickness. The ongoing pregnancy rate was significantly increased at all levels of compaction compared with no compaction. The ongoing pregnancy rate showed a significant increase with each decreasing quartile of change in thickness (increased percentage of compaction) in the progesterone phase compared with the estrogen phase. Conclusion(s):There is a highly significant inverse correlation between the ongoing pregnancy rate and the change of endometrial thickness between the end of estrogen administration and the day of embryo transfer (Fertil Steril Ò 2019;112:503-9. Ó2019 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

Decreased endometrial thickness between HCG day and embryo transfer day improves the pregnancy rate of IVF/ICSI cycles

“…ETC was an independent risk factor for CPR and OPR. This conclusion is consistent with that of Jigal Haas's study [3].…”

The impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst

“…Data from this study showed that endometrial thickness in recipients prior to and following progesterone had no impact on pregnancy outcomes. More recently, another cohort study including 271 FET cycles also evaluated endometrial thickness on both the end of the estrogen phase and the day of embryo transfer [14]. Interestingly, they found that a decreased endometrium (endometrial compaction) in response to progesterone results in better pregnancy outcome in FET cycles, which means that the greater the degree of compaction, the higher the ongoing pregnancy rate.…”

“…Another point is that the endometrial situation of each patients is re-evaluated on the morning of embryo transfer day also by trans-vaginal ultrasonic examination, which is a more accurate way to measure endometrial thickness. In Haas’s study, endometrial thickness was measured by means by pelvic (transabdominal) ultrasound [14]. This may explain the controversy between the totally opposite results from these two studies.…”

The effect of endometrial thickness on pregnancy outcomes of frozen-thawed embryo transfer cycles which underwent hormone replacement therapy

“…In addition, we noted that some recent studies [20,21] that have looked at the effect of endometrial changes between the transfer day and the starting of progesterone day, on clinical pregnancy outcomes. Our results suggest that endometrial compaction on transplantation day has a negative effect on clinical pregnancy outcomes.…”