Value of endometrial thickness change after human chorionic gonadotrophin administration in predicting pregnancy outcome following fresh transfer in vitro fertilization cycles
Value of endometrial thickness change after human chorionic gonadotrophin administration in predicting pregnancy outcome following fresh transfer in vitro fertilization cycles
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人绒毛膜促性腺激素给药后子宫内膜厚度变化对新鲜移植体外受精周期妊娠结局的预测价值
DOI：
10.1007/s00404-020-05763-4
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发表时间：
2020-09-03
影响因子：
2.6
通讯作者：
Kuang, Yanping
中科院分区：
文献类型：
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作者：
Huang, Jialyu;Lin, Jiaying;Kuang, Yanping
目的探讨新鲜体外受精/卵母细胞浆内单精子注射(IVF/ICSI)周期中子宫内膜厚度(EMT)自注射hCG之日至胚胎移植日之间的变化对妊娠结局的影响。根据hCG治疗后的百分比变化将患者分为三组： +GT； 下降10%， ± 平台10%， >； 上升10%。结果EMT降低组、平台组和增高组的活产率相似(分别为27.4%、29.7%和27.6%，P= 0.649)。与高原组相比，转运当天EMT降低(粗优势比[COR]0.89，95%可信区间[CI]0.72~1.11)和升高(粗优势比(COR)0.90，95%可信区间(CI)0.74~1.10)均不影响活产的可能性。在控制了主要混杂因素后，减少组和增加组的调整OR分别为0.92(95%CI 0.73~1.16)和0.92(95%CI 0.75~1.13)。结论在新的IVF/ICSI周期中，注射hCG后EMT的变化不能作为预测妊娠结局的重要信息。这一发现应该为胚胎移植当天EMT降低的患者提供放心的信息，同时质疑是否有必要在移植前重新测量EMT作为常规做法。
PurposeTo study whether the change of endometrial thickness (EMT) between the day of human chorionic gonadotrophin (hCG) administration and the day of embryo transfer has any impact on pregnancy outcome in fresh in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) cycles.MethodsThis single-center retrospective cohort study included 2620 patients undergoing their first consecutive autologous IVF/ICSI cycles from January 2003 to December 2012. Patients were categorized into three groups based on the percentage change of post-hCG EMT: > 10% decrease, ± 10% plateau and > 10% increase. The primary outcome was live birth rate.ResultsLive birth rates were similar in the EMT decrease, plateau and increase groups (27.4% [174/635], 29.7% [300/1010] and 27.6% [269/975];P= 0.649). Compared with the plateau group, both EMT decrease (crude odds ratio [cOR] 0.89, 95% confidence interval [CI] 0.72–1.11) and increase (cOR 0.90, 95% CI 0.74–1.10) on the day of transfer did not affect the likelihood of live birth. The non-significant association was maintained after controlling for major confounding factors, with the adjusted OR being 0.92 (95% CI 0.73–1.16) and 0.92 (95% CI 0.75–1.13) for the decrease and increase groups, respectively.ConclusionEMT change after hCG administration did not provide significant prognostic information for pregnancy outcome in fresh IVF/ICSI cycles. This finding should offer reassuring information for patients with decreased EMT on the day of embryo transfer while questioning the necessity of EMT re-measurement prior to transfer as a routine practice.