Endometrial thickness of less than 7.5 mm is associated with obstetric complications in fresh IVF cycles: a retrospective cohort study
Endometrial thickness of less than 7.5 mm is associated with obstetric complications in fresh IVF cycles: a retrospective cohort study
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DOI：
10.1016/j.rbmo.2018.05.013
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发表时间：
2018-09-01
影响因子：
4
通讯作者：
Ben-Haroush, Avi
中科院分区：
文献类型：
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作者：
Oron, Galia;Hiersch, Liran;Ben-Haroush, Avi
研究问题：子宫内膜厚度是否影响新鲜IVF周期中产科并发症的发生？设计图：我们进行了一项回顾性队列研究，包括2008年至2014年期间在一个中心进行的新鲜胚胎移植的所有单胎分娩。比较HCG触发当天子宫内膜厚度小于75 mm和7.5 mm或以上患者的产科并发症，即先兆子痫、胎盘脱垂、前置胎盘、小于胎龄儿和早产。我们调整了混杂因素，包括产妇年龄，体重指数，吸烟，峰值雌二醇，奇偶校验，慢性高血压，孕前糖尿病，妊娠糖尿病，双胎减灭，遗传或获得性血栓形成倾向，和过去的妊娠complications.Results：在研究期间，共进行了5546新鲜胚胎移植周期，其中864单胎分娩符合纳入标准。在调整潜在的混杂因素后，发现子宫内膜厚度小于75 mm与不良产科结局风险增加相关（校正OR 1.53; 95% CI 1.03 - 2.42; P = 0.04），即使排除了既往妊娠并发症患者结论：我们的研究结果表明，薄的子宫内膜衬里与产科并发症有关，可能与不良胎盘有关。这些发现应在大型前瞻性队列研究中得到验证。
Research question: Does endometrial thickness affect the occurrence of obstetric complications in fresh IVF cycles?Design: We conducted a retrospective cohort study that included all singleton deliveries resulting from fresh embryo transfers in a single centre between 2008 and 2014. Obstetric complications, i.e. preeclampsia, placental abruption, placenta previa, small for gestational age and preterm delivery, in singleton live births were compared among patients with an endometrial thickness of less than 75 mm and 7.5 mm or over on day of HCG triggering. We adjusted for confounders, including maternal age, body mass index, smoking, peak oestradiol, parity, chronic hypertension, pre-gestational diabetes, gestational diabetes, vanishing twin, inherited or acquired thrombophilia, and past pregnancy complications.Results: A total of 5546 fresh embryo transfer cycles were carried out during the study period, of which 864 singleton deliveries met inclusion criteria. After adjusting for potential confounders, an endometrial thickness of less than 75 mm was found to be associated with increased risk for adverse obstetric outcome (adjusted OR 1.53; 95% CI 1.03 to 2.42; P = 0.04) even after excluding patients with prior pregnancy complications (adjusted OR 2.2; 95% CI 1.05 to 4.59; P = 0.035).Conclusions: Our results demonstrated that a thin endometrial lining was associated with obstetric complications that might be related to poor placentation. These findings should be validated in large prospective cohort studies.