Thin Endometrium Is Also Associated With Lower Clinical Pregnancy Rate in Unstimulated Menstrual Cycles: A Study Based on Natural Cycle IVF

Wolff, Michael von; Fäh, Monika; Roumet, Marie; Mitter, Vera; Stute, Petra; Griesinger, G.; Schwartz, A Kohl

doi:10.3389/fendo.2018.00776

Cited by 36 publications

(17 citation statements)

References 17 publications

(30 reference statements)

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“…However, direct comparison between NC-IVF and conventional IVF is hard, since hormonal milieu and treatment form differ significantly. The only NC-IVF study by von Wolff et al [15] showed reduced pregnancy rate with an endometrial thickness ≤ 7 mm, but in contrast to conventional IVF a tendency to lower pregnancy rate with thick endometria (> 11 mm). In contrast, in our study after cut-off value of 10 mm, the difference in endometrial thickness between pregnant and non-pregnant women was not statistically significant.…”

Section: Discussionmentioning

confidence: 94%

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

Tomić

Kasum

Vučić

2020

Arch Gynecol Obstet

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The aim of this study is to assess the effect of the endometrial thickness and embryo quality on the implantation potential in natural cycle IVF (NC-IVF). Methods A retrospective single-center study was performed on 552 single embryo transfers after NC-IVF. The 'quality' of the embryos was evaluated trough the number and regularity of blastomeres, degree of fragmentation, and nuclear content of cells. Endometrial thickness was measured in millimeters with transvaginal ultrasound on the day of hCG application. Results Our findings showed a statistically significant difference in successful implantation until a plateau of 10 mm is reached (p = 0.001). Only one pregnancy was achieved where endometrial thickness was less than 7 mm, and this resulted in an early miscarriage. The predictors of favorable implantation were fragmentation (≤ 10%, p < 0.05) and the number of blastomeres (preferably 8-cell, p < 0.01) on day 3. Embryo quality (R = 0.052) and endometrial thickness (R = 0.18) were closely related to pregnancy rate. The overall implantation rate per embryo transfer was 18.8%. Conclusions Embryo quality and endometrial thickness have a significant impact on implantation in NC-IVF. Highest implantation potential has an 8-cell embryo with ≤ 10% fragmentation in the third day following oocyte retrieval. Endometrial thickness of at least 7 mm seems to be the optimal edge of successful pregnancy.

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Section: Discussionmentioning

confidence: 94%

“…In addition, the embryo quality seems more favorable in NC-IVF when compared with conventional IVF [14]. A study from 2018 by von Wolff et al [15] found thin endometrium as an independent negative prognostic factor in NC-IVF.…”

Section: Introductionmentioning

confidence: 99%

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

Tomić

Kasum

Vučić

2020

Arch Gynecol Obstet

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“…For decades, the relationship between endometrial thickness (EMT) and in vitro fertilization/ intracytoplasmic sperm injection (IVF/ICSI) outcomes has always been a controversial topic (1)(2)(3). To date, most studies have shown that patients with a thin EMT (<7 or 8 mm) during IVF/ICSI tended to have adverse pregnancy outcomes, and this has caused much anxiety to both patients and physicians when confronted with a thin EMT.…”

Section: Introductionmentioning

confidence: 99%

Cumulative Live Birth Rate in Patients With Thin Endometrium: A Real-World Single-Center Experience

Yang

et al. 2020

Front. Endocrinol.

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Background: Studies have shown that patients with a thin endometrial thickness (EMT < 7 or 8 mm) during IVF/ICSI tend to have adverse pregnancy outcomes, and this has caused much anxiety to both patients and physicians when confronted with a thin EMT. Method: From January 2015 to December 2018, patients with a thin EMT < 7 mm on the day of hCG administration during their first GnRH agonist IVF/ICSI cycle were included. According to the hysteroscopy results, patients were classified into totally normal (Group A), normal with a specific abnormality (Group B), and adhesion before transfer (Group C). Result: For the 245 patients included, approximately 60% of the thin EMT cases were the result of an intrauterine operation. CLBR was 35.45% (67/189) in this group of patients. In regard to CLBR, there were significant differences among these three uterus condition groups irrespective of the number of oocytes retrieved (28.57 vs. 10.00 vs. 4.76%, P = 0.12 in oocyte ≤5; 61.36 vs. 44.67 vs. 23.63%, P = 0.00 in oocyte >5). In binary logistic regression analysis, age (OR = 0.09, P = 0.03), number of embryos available (OR = 1.71, P = 0.00), and uterine condition (OR = 6.77, P = 0.00 for group A; OR = 2.55, P = 0.04 for group B; Reference = group C), were significantly associated with CLBR. However, EMT and endometrial pattern had no impact on CLBR. Conclusion: An intrauterine operation was the main reason for a thin EMT. Thin EMT patients with a normal uterine cavity and endometrium had a significantly better CLBR compared with those with adhesions before transfer.

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“…The developed in vitro 3D implantation model may serve as a platform for further studying the RIF endometrium and to ultimately increase endometrial receptivity. Such a model is of significant potential since the current evaluation of IVF treatment failure is mostly limited to analyzing the endometrium thickness [39].…”

Section: Discussionmentioning

confidence: 99%

Novel 3D embryo implantation model within macroporous alginate scaffolds

et al. 2020

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Background: Implantation failure remains an unsolved obstacle in reproductive medicine. Previous studies have indicated that estrogen responsiveness, specifically by estrogen receptor alpha (ERα), is crucial for proper implantation. There is an utmost need for a reliable in vitro model that mimics the events in the uterine wall during the implantation process for studying the regulatory mechanisms governing the process. The current twodimensional and hydrogel-based in vitro models provide only short-term endometrial cell culture with partial functionality. Results: Endometrial biopsies showed an increase in E-cadherin expression on the typical window of implantation of fertile women, compared to negligible expression in recurrent implantation failure (RIF) patients. These clinical results indicated E-cadherin as a marker for receptivity. Three-dimensional (3D) macroporous alginate scaffolds were the base for epithelial endometrial cell-seeding and long-term culture under hormone treatment that mimicked a typical menstrual cycle. The RL95-2 epithelial cell culture in macroporous scaffolds was viable for 3 weeks and showed increased E-cadherin levels in response to estrogen. Human choriocarcinoma (JAR) spheroids were used as embryo models, seeded onto cell constructs and successfully adhered to the RL95-2 cell culture. Moreover, a second model of HEC-1A with low ERα levels, showed lower E-cadherin expression and no JAR attachment. Ecadherin expression and JAR attachment were recovered in HEC-1A cells that were transfected with ERα plasmid. Conclusions: We present a novel model that enables culturing endometrial cells on a 3D matrix for 3 weeks under hormonal treatment. It confirmed the importance of ERα function and E-cadherin for proper implantation. This platform may serve to elucidate the regulatory mechanisms controlling the implantation process, and for screening and evaluating potential novel therapeutic strategies for RIF.

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Thin Endometrium Is Also Associated With Lower Clinical Pregnancy Rate in Unstimulated Menstrual Cycles: A Study Based on Natural Cycle IVF

Cited by 36 publications

References 17 publications

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

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

Cumulative Live Birth Rate in Patients With Thin Endometrium: A Real-World Single-Center Experience

Novel 3D embryo implantation model within macroporous alginate scaffolds

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