Low body mass index is associated with ectopic pregnancy following assisted reproductive techniques: a retrospective study

Cai, Jiali; Liu, L; Jiang, Xiaoming; Li, P; Sha, Aihua; Ren, Jianzhi

doi:10.1111/1471-0528.16378

Cited by 11 publications

(13 citation statements)

References 45 publications

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“…Because of these characteristics, the EP rate was very high (3.15%) in this Chinese sample, so caution is required with the reported association of HRC with EP. However, another Chinese study investigating the association between body mass index and EP using retrospective data (n = 16,378 pregnancies) demonstrated no significant associations between endometrial preparation protocols and the risk of EP for frozen cycles 18 . Furthermore, a retrospective analysis of clinical pregnancies in Italy following single blastocyst ETs with different endometrial preparation protocols demonstrated a significantly higher EP rate for natural cycles (6/561, 3.28%) than HRC (4/585, 1.83%) and modified natural cycles (3/1749, 0.4%) 19 .…”

Section: Discussionmentioning

confidence: 95%

“…Although many studies have investigated endometrial preparation protocols and pregnancy and live birth rates 27 – 29 , only a limited number of studies with conflicting results have investigated endometrial preparation protocols and the risk of EP 12 , 18 , 19 . Importantly, these studies did not specifically investigate endometrial preparation protocols and targeted other factors.…”

Section: Discussionmentioning

confidence: 99%

“…To date, only a few studies reported an association between endometrial preparation protocols on EP and results were conflicting 12 , 18 , 19 . In China, recent studies investigating the effect of endometrial thickness on EP in frozen-thawed ET cycles reported that the EP rate for HRC cycles was more than double the rate for natural cycles (4.7% vs. 2.1%, respectively) 12 .…”

Section: Introductionmentioning

confidence: 99%

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Effect of endometrial preparation protocols on the risk of ectopic pregnancy for frozen embryo transfer

Jwa

Takamura

Kuwahara

et al. 2021

Sci Rep

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Studies have consistently reported a significantly reduced incidence of ectopic pregnancy (EP) for frozen-thawed embryo transfer (ET) cycles compared with fresh cycles. However, only a few studies reported an association between endometrial preparation protocols on EP and results were conflicting. A registry-based retrospective cohort study of 153,354 clinical pregnancies following frozen single ETs between 2014 and 2017 were conducted, of which 792 cases of EP (0.52%) were reported. Blastocyst embryo transfers accounted for 87% of the total sample and were significantly associated with a decreased risk for EP compared with early cleavage ET (0.90% vs. 0.46%, adjusted OR = 0.50, 95% CI, 0.41 to 0.60). Compared with natural cycles, hormone replacement cycles (HRC) demonstrated a similar risk for EP (0.53% vs. 0.47%, adjusted OR = 1.12, 95% CI, 0.89 to 1.42). Subgroup analysis with or without tubal factor infertility and early cleavage/blastocyst ETs demonstrated similar non-significant associations. Endometrial preparation protocols using clomiphene (CC) were associated with a significantly increased risk for EP (1.12%, adjusted OR = 2.34; 95% CI, 1.38 to 3.98). These findings suggest that HRC and natural cycles had a similar risk for EP. Endometrial preparation using CC was associated with an increased risk of EP in frozen embryo transfer cycles.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of endometrial preparation protocols on the risk of ectopic pregnancy for frozen embryo transfer

Jwa

Takamura

Kuwahara

et al. 2021

Sci Rep

View full text Add to dashboard Cite

show abstract

“…We used the female age [9,10,33] , body mass index (BMI) [34] , the duration of infertility, gravidity [35] , previous history of ectopic pregnancy [36,37 ], ovarian stimulation/endometrial preparation protocol [38] , number of embryos transferred [18,35] , the main causes of infertility [18] , and frozen-thawed/ fresh embryos transferred [39,40] as matching factors because previous study have determined that these factors are associated with the occurrence of EP, and our goal in the present study was to analyze the relationship between endometrial features and embryonic development stage and EP. Our study reduced bias of population selection by adjustment of matching the time for infertility treatment.…”

Section: Risk Factor Selectionmentioning

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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“…We used the female age [9,10,33] , body mass index (BMI) [34] , the duration of infertility, gravidity [35] , previous history of ectopic pregnancy [36,37], ovarian stimulation/endometrial preparation protocol [38] , number of embryos transferred [18,35] , the main causes of infertility [18] , and frozen-thawed/ fresh embryos transferred [39,40] as matching factors because previous study have determined that these factors are associated with the occurrence of EP, and our goal in the present study was to analyze the relationship between endometrial features and embryonic development stage and EP. Our study reduced bias of population selection by adjustment of matching the time for infertility treatment.…”

Section: Risk Factor Selectionmentioning

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

View full text Add to dashboard Cite

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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Low body mass index is associated with ectopic pregnancy following assisted reproductive techniques: a retrospective study

Abstract: Objective To investigate the association between body mass index (BMI) and ectopic pregnancy (EP) following embryo transfer (ET).Design Retrospective cohort study.Setting University-affiliated hospital.

Cited by 11 publications

References 45 publications

Effect of endometrial preparation protocols on the risk of ectopic pregnancy for frozen embryo transfer

Effect of endometrial preparation protocols on the risk of ectopic pregnancy for frozen embryo transfer

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

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

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