Impact of endometrial thickness change in response to progesterone on live birth rates embryo transfers with fresh oocyte donation cycles

Gursu, Turkan; Çelik, Hale Göksever; Eraslan, Alper; Angun, Berk; Ozaltin, Selin; Yeh, John; Baştu, Ercan

doi:10.1080/01443615.2022.2112022

Cited by 6 publications

(7 citation statements)

References 21 publications

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“…In five studies of FET-HRT ( 13 , 14 , 22 , 23 , 31 ) and one study with fresh oocyte donation ( 26 ), ECR was defined as the rate of change in EMT between the day of progesterone administration and the day of ET. In 7 other FET-HRT studies ( 12 , 18 – 20 , 24 , 25 , 28 ), ECR was defined as the rate of change at which EMT changed from the end of estrogen-only phase to the ET or the day before the ET.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 7 prospective studies and 11 retrospective studies were included. Of these, 11 studies ( 17 , 18 , 20 – 22 , 24 , 26 – 29 , 31 ) did not find a statistically significant association between endometrial compaction and pregnancy outcomes, whereas in 5 studies ( 12 , 19 , 23 , 25 , 30 ) better pregnancy outcomes were reported. In contrast, Bu et al.…”

Section: Discussionmentioning

confidence: 98%

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Does endometrial compaction before embryo transfer affect pregnancy outcomes? a systematic review and meta-analysis

Chen,

Sun,

Song

2023

Front. Endocrinol.

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ObjectiveThere is no clear evidence of clinical significance of endometrial compaction, which can be measured by a reduction in endometrial thickness (EMT) during the follicular-luteal transition before the day of embryo transfer. In this study, we aim to determine whether endometrial compaction has an effect on in vitro fertilization (IVF) success.Method(s)We searched PubMed, Cochrane, Embase, and Web of Science electronic databases for studies published in English up to March 2023. Heterogeneity between studies was assessed using the I2 statistic. The random effects model and fixed effects model was used to pool the risk ratio (RR) with a corresponding 95% confidence interval (CI). A subgroup analysis was performed based on different methods of ultrasonic measurement and different endometrial compaction rates (ECR). Stata 17.0 software was used for meta-analysis. Pregnancy outcomes, which included clinical pregnancy rate, ongoing pregnancy rate, live birth rate, and spontaneous abortion rate, were evaluated.Result(s)In this study, 18 cohort studies were included, involving 16,164 embryo transfer cycles. Pooled results indicated that there was no significant difference between the endometrial compaction group and the non-compaction group in terms of clinical pregnancy rate (RR [95% CI]=0.98 [0.90,1.08]; I2 = 69.76%), ongoing pregnancy rate (RR [95% CI]=1.18 [0.95,1.47]; I2 = 78.77%), live birth rate (RR [95% CI]= 0.97 [0.92,1.02]; I2 = 0.00%) or spontaneous abortion rate (RR [95% CI]= 1.07[0.97,1.26]; I2 = 0.00%). According to the subgroup analysis of ultrasonic measurement methods, in the transvaginal ultrasound (TVUS) combined with abdominal ultrasonography (AUS) cycles of the endometrial compaction group, the rate of ongoing pregnancy (RR [95% CI] = 1.69 [1.26, 2.26]; I2 = 29.27%) and live birth (RR [95% CI] = 1.27 [1.00,1.61]; I2 = 62.28%) was significantly higher than that of the non-compaction group. Additionally, subgroup analysis based on ECR revealed a significantly higher rate of ongoing pregnancy when ECR ≥ 15% (RR [95% CI] = 1.99 [1.61, 2.47]; I2 = 0.00%).ConclusionEndometrial compaction has no adverse effect on clinical pregnancy rate, ongoing pregnancy rate, live birth rate, or spontaneous abortion rate. A possible explanation for the contradictory findings of previous studies lies in the method by which the EMT is measured.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023430511, identifier CRD42023430511.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 98%

Does endometrial compaction before embryo transfer affect pregnancy outcomes? a systematic review and meta-analysis

Chen,

Sun,

Song

2023

Front. Endocrinol.

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“…Ata et al 34 reported no linear relationship of endometrial thickness with live birth rate, and no predictive value of endometrial thickness for live birth rate. Gursu et al 35 mentioned that the endometrial thickness measurement in patients undergoing the infertility treatment may provide little benefit to clinical outcomes. Previous studies showed that endometrial thickness on the day of hCG administration can be a potential prognostic tool for the outcomes of the assisted reproductive technology, which serve as an indicator of endometrial receptivity.…”

Section: Discussionmentioning

confidence: 99%

Assisted Reproductive Technology Outcomes in Women with Normal Ovarian Response Receiving Recombinant Luteinizing Hormone/Human Menopausal Gonadotropin: An Observational Study

Liang,

Hou,

Chen

et al. 2024

IJWH

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“…In recent years, several studies have tried to determine if EC is linked to reproductive outcomes with inconsistent evidence published ( Haas et al , 2019 ; Zilberberg et al , 2020 ; Riestenberg et al , 2021 ; Yaprak et al , 2021 ; Shah et al , 2022 ). Some authors report no correlation between EC and pregnancy outcomes ( Huang et al , 2020 , 2021 ; Jarrah et al , 2021 ; Riestenberg et al , 2021 ; Gursu et al , 2022 ; Shah et al , 2022 ), whilst others have observed a positive association between EC and pregnancy rates ( Haas et al , 2019 ; Zilberberg et al , 2020 ; Kaye et al , 2021 ; Yaprak et al , 2021 ; Youngster et al , 2022 ). If shown to be beneficial, EC could be a valuable way to help predict pregnancy outcomes in patients undergoing ART and could be an inexpensive method of guiding the timing of ET to synchronise with endometrial receptivity.…”

Section: Introductionmentioning

confidence: 99%

Endometrial compaction to predict pregnancy outcomes in patients undergoing assisted reproductive technologies: a systematic review and meta-analysis

Al-Lamee,

Stone,

Powell

et al. 2024

Human Reproduction Open

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STUDY QUESTION Does endometrial compaction (EC) help predict pregnancy outcomes in those undergoing ART? SUMMARY ANSWER EC is associated with a significantly higher clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR), but this does not translate to live birth rate (LBR). WHAT IS KNOWN ALREADY EC describes the progesterone-induced decrease in endometrial thickness, which may be observed following the end of the proliferative phase, prior to embryo transfer. EC is proposed as a non-invasive tool to help predict pregnancy outcome in those undergoing ART, however published data is conflicting. STUDY DESIGN, SIZE, DURATION A literature search was carried out by two independent authors using PubMed, Cochrane Library, MEDLINE, Embase, Science Direct, Scopus and Web of Science from inception of databases to May 2023. All peer-reviewed studies reporting EC and pregnancy outcomes in patients undergoing IVF/ICSI treatment were included. PARTICIPANTS/MATERIALS, SETTING, METHODS The primary outcome is LBR. Secondary outcomes included other pregnancy metrics (positive pregnancy test (PPT), CPR, OPR, miscarriage rate (MR)) and rate of EC. Comparative meta-analyses comparing EC and no EC were conducted for each outcome using a random-effects model if I2>50%. The Mantel-Haenszel method was applied for pooling dichotomous data. Results are presented as odds ratios (OR) with 95% CI. MAIN RESULTS AND THE ROLE OF CHANCE Out of 4,030 screened articles, 21 cohort studies were included in the final analysis (n = 27,857). No significant difference was found between LBR in the EC versus the no EC group (OR 0.95; 95% CI 0.87-1.04). OPR was significantly higher within the EC group (OR 1.61; 95% CI 1.09- 2.38), particularly when EC ≥ 15% compared to no EC (OR 3.52; 95% CI 2.36-5.23). CPR was inconsistently defined across the studies, affecting the findings. When defined as a viable intrauterine pregnancy <12 weeks, EC group had significantly higher CPR than no EC (OR 1.83; 95% CI 1.15-2.92). No significant differences were found between EC and no EC for PPT (OR 1.54; 95% CI 0.97-2.45) or MR (OR 1.06; 95% CI 0.92-1.56). The pooled weighted incidence of EC across all studies was 32% (95% CI 26-38%). LIMITATIONS, REASONS FOR CAUTION Heterogeneity due to differences between reported pregnancy outcomes, definition of EC, method of ultrasound and cycle protocol, may account for the lack of translation between CPR/OPR and LBR findings, thus, all pooled data should be viewed with an element of caution. WIDER IMPLICATIONS OF THE FINDINGS In this dataset, the significantly higher CPR/OPR with EC does not translate to LBR. Although stratification of women according to EC cannot currently be recommended in clinical practice, a large and well-designed clinical trial to rigorously assess EC as a non-invasive predictor of a successful pregnancy is warranted. We urge for consistent outcome reporting to be mandated for ART trials so that data can be pooled, compared, and concluded on. STUDY FUNDING/COMPETING INTEREST(S) H.A. is supported by the Hewitt Fertility Centre. S.G.P. and J.W. are supported by the Liverpool University Hospital NHS Foundation Trust. D.K.H. is supported by a Wellbeing of Women project grant (RG2137) and MRC clinical research training fellowship (MR/V007238/1). NT is supported by the National Institute for Health and Care Research. D.K.H. has received honoraria for consultancy for Theramex and has received payment for presentations from Theramex and Gideon Richter. The remaining authors have no conflicts of interests to report. REGISTRATION NUMBER PROSPERO CRD42022378464

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Impact of endometrial thickness change in response to progesterone on live birth rates embryo transfers with fresh oocyte donation cycles

Cited by 6 publications

References 21 publications

Does endometrial compaction before embryo transfer affect pregnancy outcomes? a systematic review and meta-analysis

Does endometrial compaction before embryo transfer affect pregnancy outcomes? a systematic review and meta-analysis

Assisted Reproductive Technology Outcomes in Women with Normal Ovarian Response Receiving Recombinant Luteinizing Hormone/Human Menopausal Gonadotropin: An Observational Study

Endometrial compaction to predict pregnancy outcomes in patients undergoing assisted reproductive technologies: a systematic review and meta-analysis

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