Endometrial thickness as a predictor of ectopic pregnancy in 1125 in vitro fertilization-embryo transfer cycles: a matched case–control study

Liu, Xitong; Qu, Pengfei; Bai, Haiyan; Shi, Wenhao; Shi, Juanzi

doi:10.1007/s00404-019-05353-z

Cited by 25 publications

(39 citation statements)

References 20 publications

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“…It is generally believed that a thicker endometrium facilitates embryo implantation, and one study indicates that an endometrial thickness >12 mm is a strong protective factor against ectopic pregnancy (41). Nevertheless, other investigators have also reported that a thicker endometrium may result in a low pregnancy rate (42), and a very recent study reported that the pregnancy rate after frozen-thawed embryo transfer was significantly decreased in patients whose endometrium was >7 mm compared with those whose endometrium was <7 mm (43).…”

Section: Discussionmentioning

confidence: 99%

The value of transvaginal 4-dimensional hysterosalpingo-contrast sonography in predicting the necessity of assisted reproductive technology for women with tubal factor infertility

Gu¹,

Yang²,

Zhao³

et al. 2021

Quant Imaging Med Surg

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Background: More than 50 million women suffer from infertility worldwide, among whom 30% have associated fallopian tube pathology. Fortunately, the diagnostic accuracy of tubal patency has been enhanced with the consistent development of ultrasound imaging technology, especially the invention of transvaginal 4-dimensional hysterosalpingo-contrast sonography (TV 4D HyCoSy). However, detailed imaging data for evaluating the tubal condition for spontaneous conception and assessing the necessity of assisted reproductive technology (ART) have yet to be amassed.Methods: Patients with tubal factor infertility (TFI) who received TV 4D HyCoSy were recruited for this study. They were divided into two groups according to the method of conception: the natural pregnancy group (patients who naturally conceived within 3 months after TV 4D HyCoSy) and the assisted reproduction group (patients who failed to conceive naturally within the 3 months but successfully conceived through ART). Logistic regression analysis was performed to examine the data obtained from participants' medical history and TV 4D HyCoSy investigation.Results: Of the initial 1,433 women, 348 were excluded due to exclusion criteria or lack of follow-up. A total of 1,085 TFI patients were finally included, with individuals in the natural pregnancy group accounting for 27.74% (n=301), and those in the ART group accounting for 37.33% (n=405). The age was younger and the duration of infertility was shorter in the group of women who conceive spontaneously after TV 4D HyCoSy (P<0.05). In terms of imaging data, their endometrial thickness was thinner, right fallopian tube wall was more intact, morphology of the right fallopian tube was smoother, and their ovarian motility (bilateral), fallopian tube visualization (bilateral) and overflow condition of the contrast agent from the fimbriae of fallopian tube (bilateral) were better. In addition, the resistance of the contrast agent injection was less likely to be persistent, reflux was less likely to happen and 0/1 dispersion of the contrast agent around the ovary (bilateral) were more likely to be annular (P<0.05). Conclusions:The imaging data gathered from TV 4D HyCoSy in TFI patients were comprehensive, which suggested that TV 4D HyCoSy could have potential to be used to assess the necessity of post-HyCoSy ART intervention in patients with TFI. This could be of benefit in reducing the incidence of overtreatment and potential complications of ART.

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Section: Discussionmentioning

confidence: 99%

The value of transvaginal 4-dimensional hysterosalpingo-contrast sonography in predicting the necessity of assisted reproductive technology for women with tubal factor infertility

Gu¹,

Yang²,

Zhao³

et al. 2021

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…Few studies use EMT during ART therapy to predict future EP, the cutoff value for EP associated EMT is also debated. One study showed that the EMT > 12 mm (OR 0.27; 95% CI 0.13-0.56) prior to embryo transfer was a protective factor against EP [64] . Our study showed that, for fresh cycles, the EMT of the EP group on transformation day was signi cantly lower than that of the IUP group, the best cutoff point was 9.35mm, the thinner the endometrial was, the more likely EP would occur.…”

Section: Discussionmentioning

confidence: 99%

Thin Endometrium and Cleavage Embryo Transfer Are Associated With Ectopic Pregnancy After in Vitro Fertilization‑embryo Transfer Cycles: a Matched Case–control Study Using Propensity Score Matching

Zhao

Liu

et al. 2021

Preprint

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Objective: To evaluate the relationship between the endometrial features (endometrial thickness(EMT), pattern and endometrium growth amplitude and rate) and the embryo stage transferred and ectopic pregnancy after IVF-ET based on the data of 628 matched cases. Methods: This was a 1:1 matched case-control study that enrolled 314 EP patients and 314 matched IUP patients from the ART center of Xiangya Hospital of Central South University from January 2014 to April 2020. Univariate analysis and multiple-stepwise logistic regression analysis was used to analyze the risk factors of EP, and a receiver-operating characteristic (ROC) curve was generated to predict EP. Results: 1. The EP group had a higher cleavage stage embryo transfer rate(94.57% vs 86.22%), a thinner endometrium on transformation day(the day when progesterone was added in the frozen embryo cycle or the trigger day in the fresh embryo cycle) (9.40(2.60) mm vs 9.80(2.60)mm) compared with IUP group. In fresh embryo cycles, the EP group had a higher endometrium pattern C proportion on transformation day, a smaller endometrium increment, and a slower endometrial growth rate compared with the IUP group. 2.The ROC curves were used to analyze the cut-off values of the EMT on transformation day, the endometrial growth amplitude and rate in fresh cycles, the results were 9.35mm, 4.90mm and 0.491 mm/d, respectively. The incidence of EP was significantly different between groups according to cut-off values. 3.The transferred embryo stage and EMT on transformation day were independent factors affecting outcome in the general population. The area under the curve(AUC) of the EMT and the stage of embryos transferred for EP prediction was 0.604, sensitivity was 0.702, and specificity was 0.465. The EMT on trigger day was an independent factor affecting outcome in the fresh cycles. The AUC of the EMT for EP prediction in fresh cycles was 0.605, sensitivity was 0.805, and specificity was 0.420. Conclusions: 1. Transferring cleavage stage embryo, and thin EMT on the transformation day were risk factors for EP. 2. Thin EMT and pattern C on transformation day may be related to abnormal endometrial receptivity and endometrial peristaltic waves. 3.The combined indicator of EMT and embryonic development stage could not well predict the occurrence of EP after ET.

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“…Based on previously published articles, the following risk factors were included ( 9 , 10 ): age; body mass index (BMI); infertility duration; infertility factors (tubal factor, ovulation disorders, endometriosis, polycystic ovary syndrome, uterine dysplasia, uterine leiomyoma, chromosome abnormalities and unexplained infertility); gravidity; miscarriages; previous EP; treatment of last EP; type of ART; type of embryo transferred; stage of embryo; FET protocols; number of embryos transferred.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors of Recurrent Ectopic Pregnancy in Patients Treated With in vitro Fertilization Cycles: A Matched Case-Control Study

Shi

et al. 2020

Front. Endocrinol.

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Objective: To study the risk factors for recurrent ectopic pregnancy (REP) in patients undergoing in vitro fertilization (IVF). Methods: This was a 1:4 matched case-control study that enrolled 227 REP patients and 908 matched intrauterine pregnancy (IUP) patients from the assisted reproductive technology (ART) center of the First Affiliated Hospital of Zhengzhou University from January 2012 to November 2019. Univariate analysis was carried out between the two groups for the occurrence of REP. Multivariate logistic regression analysis was used to explore the risk factors of REP after IVF. Results: The results of univariate analysis showed that there were significant differences in previous treatment of EP, stage of embryo and the number of embryos transferred between the two groups (all P < 0.05). The other factors did not have a significant effect on the probability of developing REP. Multivariate logistic regression analysis showed that after adjusting for confounders, previous treatment of EP, type of embryos transferred and stage of embryo were related to the occurrence of REP (all P < 0.05). Conclusion: Conservative treatment, frozen-thawed embryo transfer and cleavage embryo transfer were independent risk factors for REP after ART treatment.

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Endometrial thickness as a predictor of ectopic pregnancy in 1125 in vitro fertilization-embryo transfer cycles: a matched case–control study

Cited by 25 publications

References 20 publications

The value of transvaginal 4-dimensional hysterosalpingo-contrast sonography in predicting the necessity of assisted reproductive technology for women with tubal factor infertility

The value of transvaginal 4-dimensional hysterosalpingo-contrast sonography in predicting the necessity of assisted reproductive technology for women with tubal factor infertility

Thin Endometrium and Cleavage Embryo Transfer Are Associated With Ectopic Pregnancy After in Vitro Fertilization‑embryo Transfer Cycles: a Matched Case–control Study Using Propensity Score Matching

Risk Factors of Recurrent Ectopic Pregnancy in Patients Treated With in vitro Fertilization Cycles: A Matched Case-Control Study

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