The Impact of Endometrial Thickness on the Day of Human Chorionic Gonadotrophin (hCG) Administration on Ongoing Pregnancy Rate in Patients with Different Ovarian Response

Abstract

In order to explore the impact of endometrial thickness on hCG administration day on ongoing pregnancy rate (OPR) in IVF-ET cycles, we retrospectively analyzed data from 10,406 patients undergoing their first IVF cycles with standard gonadotropin releasing hormone analogue (GnRH-a) long protocol. Firstly, patients were divided into poor (≤ 5 oocytes), medium (6–14 oocytes), and high (≥ 15 oocytes) ovarian responders based on the number of oocytes retrieved. In each group, patients were sub-divided into three groups according to the endometrial thickness on the day of hCG administration: Group A, thin endometrial thickness (≤ 7 mm); Group B, medium endometrial thickness (8–13 mm); Group C, thick endometrial thickness (≥ 14 mm). (1) For poor responders, OPRs were significantly different in the three endometrial thickness groups (28.57%, 44.25%, and 51.34%; P = 0.008). The association between thin endometrial thickness and OPR was significant after controlling for age, number of embryos transferred by multivariate logistic regression analysis (adjusted OR: 0.408; 95% CI: 0.186–0.898; P = 0.026. Reference = thick endometrial thickness). (2) For medium responders, OPRs were 31.58%, 55.56%, and 63.01% (P = 0.000) in the three groups. Adjusted OR for thin endometrial thickness was 0.284 (95% CI: 0.182–0.444; P = 0.000). (3) For high responders, OPRs were also significantly different in the three groups (28.13%, 52.63%, and 63.18; P = 0.000). Adjusted OR for thin endometrial thickness was 0.233 (95% CI: 0.105–0.514; P = 0.000). For patients undergoing IVF with different ovarian response, a thin endometrium on the day of hCG administration adversely affects ongoing pregnancy rate.

Impact of embryo quality and endometrial thickness on implantation in natural cycle IVF

“…In our study, endometrial thickness of at least 7 mm is found to be the optimal margin for successful implantation in NC-IVF. Conflicting results exist concerning the possible relationship between endometrial thickness and treatment outcome after IVF [3,[6][7][8]25]. The majority of previous studies reported small series (less than 200 cycles) or used different ovarian stimulation protocols.…”

“…Findings are, however, inconclusive due to different induction protocols in use, limited sample sizes and various inclusion criteria [6][7][8][9]. Embryo quality is primarily assessed through an embryo grading system where embryos are graded according to their morphological appearance and are given a score that relates to their development at the time of assessment [10].…”

The correlation between endometrial thickness and pregnancy outcomes in fresh ART cycles with different age groups: a retrospective study

“…In order to get a more accurate relationship between endometrial thickness and IVF outcome, Bu et al demonstrated that for the patient undergoing IVF with the different ovarian response, a thin endometrial thickness on HCG administration day is associated with lower pregnancy rate [10]. A thick endometrium is more controversial.…”

“…Patients with extremely low levels of AMH still can achieve reasonable treatment outcomes and should not be precluded from attempting IVF solely on the basis of an AMH value [21]. Studies showed that an increasing number of total oocytes, zygotes, and the quality of embryos are associated with live birth following donor oocyte IVF cycles [10,22]. Barton et al found that age and E2 on the day of hCG administration were predictive of mature oocytes and embryos retrieved, but FSH was not [23].…”

Endometrial thickness and IVF cycle outcomes: a meta-analysis

“…Of the 2874 potentially relevant studies screened by electronic databases, 2830 were excluded owing to irrelevant and duplicate topics. The full-text articles for the remaining 44 studies were evaluated, and 30 studies met the inclusion criteria and were included in this study (Rinaldi et al, 1996;Weissman et al, 1999;De Geyter et al, 2000;Basir et al, 2002;Dietterich et al, 2002;Yoeli et al, 2004;Aboulghar et al, 2005;Rashidi et al, 2005;Zhang et al, 2005;Amir et al, 2007;Richter et al, 2007;McWilliams and Frattarelli, 2007;Al-Ghamdi et al, 2008;Dechaud et al, 2008;Bozdag et al, 2009;Okohue et al, 2009;Traub et al, 2009;Chen et al, 2010;Kinay et al, 2010;Kuc et al, 2011;Singh et al, 2011;Zhao et al, 2012;Wu, 2014;Bu and Sun, 2015;Fang et al, 2016;Yuan et al, 2016;Liu et al, 2018;Ribeiro et al, 2018;Wang et al, 2018;Yang et al, 2018). No new eligible studies were found after a manual search of the reference lists.…”