Optimal endometrial thickness to maximize live births and minimize pregnancy losses: Analysis of 25,767 fresh embryo transfers

Gallos, Ioannis D; Khairy, Mohammed; Chu, Justin; Rajkhowa, Madhurima; Tobías, Aurelio; Campbell, Alison; Dowell, Ken; Fishel, Simon; Coomarasamy, Arri

doi:10.1016/j.rbmo.2018.08.025

Cited by 72 publications

(45 citation statements)

References 17 publications

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“…The threshold for endometrial thickness on our transformation day was set to 8 mm. Some studies have suggested that an endometrial thickness of ≥8 mm leads to better FET outcomes [ 5 ]. 4.…”

Section: Discussionmentioning

confidence: 99%

Gonadotropin-releasing hormone agonist combined with hormone replacement therapy does not improve the reproductive outcomes of frozen-thawed embryo transfer cycle in elderly patients: a retrospective study

Dong

Sun

Huang

et al. 2020

Reprod Biol Endocrinol

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Background With the rapid development of whole embryo freezing technology, more and more frozen-thawed embryo transfer (FET) was used in assisted reproductive technology. However, the best FET program for elderly women has not been finalized. We intended to explore the reproductive outcomes of traditional hormone replacement treatment and a gonadotropin-releasing hormone agonist (GnRHa) combined with hormone replacement treatment in the frozen-thawed embryo transfer cycle of elderly patients. Methods In this retrospective analysis, we analyzed 1264 elderly patients (aged 38 years or older) who underwent FET at three reproductive centers between 2015 and 2017. According to the endometrial preparation protocol, we divided the patients into a GnRHa combined with hormone replacement treatment (GnRHa-HRT) group and traditional hormone replacement treatment (HRT) group. The clinical pregnancy, ongoing pregnancy, live birth, and abortion rates were compared between groups. Results One-way analysis of variance of the two groups revealed no significant difference in the clinical (33.58% vs. 37.15%) and ongoing pregnancy rates (19.40% vs. 25.10%) between the GnRHa-HRT and HRT groups. The live birth rate (17.54% vs. 24.10% p = 0.0229) of the GnRHa-HRT group was lower than that of the HRT group, whereas the abortion rate (45.56% vs. 32.97% p = 0.0252) was higher than that of the HRT group. However, multivariate analysis showed no significant difference in the live birth rate ( p = 0.1333) or abortion rate ( p = 0.1881) between the GnRHa-HRT and HRT groups. The number of embryos transferred, level of the embryo, and age and ovarian reserve of the patient significantly affected final reproductive outcomes. Conclusion A GnRH agonist combined with hormone replacement therapy did not improve the reproductive outcomes of frozen-thawed embryo cycles in elderly patients.

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Section: Discussionmentioning

confidence: 99%

Gonadotropin-releasing hormone agonist combined with hormone replacement therapy does not improve the reproductive outcomes of frozen-thawed embryo transfer cycle in elderly patients: a retrospective study

Dong

Sun

Huang

et al. 2020

Reprod Biol Endocrinol

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“…, 2007 ), but also by unknown factors at, for instance, the sperm or endometrium level ( Simon et al. , 2014 ; Gallos et al. , 2018 ; Liu et al.…”

Section: The More Oocytes the Better?mentioning

confidence: 99%

Individualized ovarian stimulation in IVF/ICSI treatment: it is time to stop using high FSH doses in predicted low responders

et al. 2019

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In IVF/ICSI treatment, the FSH starting dose is often increased in predicted low responders from the belief that it improves the chance of having a baby by maximizing the number of retrieved oocytes. This intervention has been evaluated in several randomized controlled trials, and despite a slight increase in the number of oocytes—on average one to two more oocytes in the high versus standard dose group—no beneficial impact on the probability of a live birth has been demonstrated (risk difference, −0.02; 95% CI, −0.11 to 0.06). Still, many clinicians and researchers maintain a highly ingrained belief in ‘the more oocytes, the better’. This is mainly based on cross-sectional studies, where the positive correlation between the number of retrieved oocytes and the probability of a live birth is interpreted as a direct causal relation. If the latter would be present, indeed, maximizing the oocyte number would benefit our patients. The current paper argues that the use of high FSH doses may not actually improve the probability of a live birth for predicted low responders undergoing IVF/ICSI treatment and exemplifies the flaws of directly using cross-sectional data to guide FSH dosing in clinical practice. Also, difficulties in the de-implementation of the increased FSH dosing strategy are discussed, which include the prioritization of intermediate outcomes (such as cycle cancellations) and the potential biases in the interpretation of study findings (such as confirmation or rescue bias).

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“…EMT can also be measured on the day of oocyte retrieval and have been alleged to predict the endometrial receptivity during fresh IVF cycles (32). In general, EMT should exceed 8 mm as the threshold of endometrial receptivity in fresh embryo transfer cycles (33), although other studies suggest 10 mm of EMT may be better for a more stable implantation of embryos and minimization of pregnancy losses (34). Hence, increasing endometrial thickness and uterine perfusion might be beneficial goals for improving endometrial receptivity.…”

Section: Clinical Evidence Of Gh On Endometrial Receptivitymentioning

confidence: 99%

The Potential Role of Growth Hormone on the Endometrium in Assisted Reproductive Technology

Liu

Yan

et al. 2020

Front. Endocrinol.

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Growth hormone (GH) has been considered as an adjuvant treatment in human assisted reproductive technology (ART) for several years. Its action was largely attributed to an improvement of ovarian function and less emphasis was paid to its role in the uterus. However, there is increasing evidence that GH and its receptors are expressed and have actions in the endometrium and may play an important role in modifying endometrial receptivity. Thus, in this review, we firstly describe the existence of GH receptors in endometrium and then summarize the effects of GH on the endometrium in clinical situations and the underlying mechanisms of GH in the regulation of endometrial receptivity. Finally, we briefly review the potential risks of GH in ART and consider rationalized use of GH treatment in ART.

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Optimal endometrial thickness to maximize live births and minimize pregnancy losses: Analysis of 25,767 fresh embryo transfers

Cited by 72 publications

References 17 publications

Gonadotropin-releasing hormone agonist combined with hormone replacement therapy does not improve the reproductive outcomes of frozen-thawed embryo transfer cycle in elderly patients: a retrospective study

Gonadotropin-releasing hormone agonist combined with hormone replacement therapy does not improve the reproductive outcomes of frozen-thawed embryo transfer cycle in elderly patients: a retrospective study

Individualized ovarian stimulation in IVF/ICSI treatment: it is time to stop using high FSH doses in predicted low responders

The Potential Role of Growth Hormone on the Endometrium in Assisted Reproductive Technology

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