The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles
The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles
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DOI：
10.1016/j.fertnstert.2007.04.031
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发表时间：
2008-04-01
影响因子：
6.7
通讯作者：
Braude, Peter
中科院分区：
文献类型：
--
作者：
El-Toukhy, Tarek;Coomarasamy, Arri;Braude, Peter
目的：探讨子宫内膜厚度与药物冻融胚胎置换（FER）周期结局的关系。设计：回顾性观察性研究。地点：一所大学医院的辅助受孕病房。患者：1997年至2006年4月期间所有经历过FER周期且符合纳入标准的患者。干预(S)：对于子宫内膜准备，从月经第1天开始口服戊酸E-2，每日剂量为6mg，当子宫内膜厚度达到7mm或更多时，给予P片（每日800 mg）， 2-3天后进行ET。根据补磷当天子宫内膜厚度测定，对各周期进行分级。主要结局指标：着床率、临床妊娠率、持续妊娠率和活产率。结果：共分析了768个连续用药周期。子宫内膜厚度为14 mm的孕妇妊娠率最低。（n = 1.2，两组7%）。与子宫内膜厚度为7-8转（n = 357）的周期相比，子宫内膜厚度为9-14毫米（n = 386）的周期获得了更高的着床率（19%对12%）、临床妊娠率（30%对18%）、持续妊娠率（27%对16%）和活产率（25%对14%）。在校正混杂变量后，这些差异仍然显著（临床妊娠的校正优势比[OR] = 1.83[置信区间{CI} = 1.3-2.6]，持续妊娠的校正优势比[OR] = 1.8 [CI = 1.2-2.6]，活产的校正优势比[OR] = 1.9 [CI = 1.3-2.8]）。结论(S)：在给药周期中，与子宫内膜厚度为7-8 mm的孕妇相比，在补磷当天测量的子宫内膜厚度为9-14 mm的孕妇着床率和妊娠率更高。
Objective: To examine the relationship between endometrial thickness and outcome of medicated frozen-thawed embryo replacement (FER) cycles.Design: A retrospective observational study.Setting: Assisted conception unit at a university hospital.Patient(s): All patients who underwent an FER cycle between 1997 and April 2006 and met the inclusion criteria.Intervention(S): For endometrial preparation, a daily dose of 6 mg of oral E-2 valerate was started on menstrual day 1, and P pessaries (800 mg daily) were administrated when the endometrial thickness had reached 7 mm or more, with ET taking place 2-3 days later. The FER cycles were categorized according to endometrial thickness measurement on the day of P supplementation.Main Outcome Measure(s): Implantation, clinical pregnancy, ongoing pregnancy, and live birth rates.Result(s): In all, 768 consecutive medicated FER cycles were analyzed. The lowest pregnancy rates were associated with endometrial thickness 14 mm. (n = 1.2; 7% in both groups). Significantly higher implantation (19% vs. 12%), clinical pregnancy (30% vs. 18%), ongoing pregnancy (27% vs. 16%), and live birth (25% vs. 14%) rates were achieved in cycles where endometrial thickness was 9-14 mm (n = 386), compared with those in which endometrial thickness was 7-8 turn (n = 357). These differences remained significant after adjusting for confounding variables (adjusted odds ratio [OR] = 1.83 [confidence interval {CI} = 1.3-2.6] for clinical pregnancy, 1.8 [CI = 1.2-2.6] for ongoing pregnancy and 1.9 [CI = 1.3-2.8] for live birth).Conclusion(S): In medicated FER cycles, an endometrial thickness of 9-14 mm measured on the day of P supplementation is associated with higher implantation and pregnancy rates compared with an endometrial thickness of 7-8 mm.