Endometrial thickness affects the outcome of in vitro fertilization and embryo transfer in normal responders after GnRH antagonist administration

Yu Wu, Xiaohong Gao, Xiang Lu, Ji Xi, Shan Jiang, Yin Sun, Xiaowei Xi, Yu Wu, Xiaohong Gao, Xiang Lu, Ji Xi, Shan Jiang, Yin Sun, Xiaowei Xi

Abstract

Background: The goal of this study was to assess the association between endometrial thickness on the chorionic gonadotropin (hCG) day and in vitro fertilization and embryo transfer (IVF-ET) outcome in normal responders after GnRH antagonist administration.

Methods: A retrospective cohort study was performed in normal responders with GnRH antagonist administration from January 2011-December 2013. Patients were divided into four groups according to endometrial thickness, as follows: <7 mm (group 1), > = 7- < 8 mm (group 2), > = 8- < 14 mm (group 3), and > =14 mm (group 4).

Results: A total of 2106 embryo transfer cycles were analyzed. The pregnancy rate (PR) was 44.87%.The clinical pregnancy rate, ongoing pregnancy rate and the implantation rate (17.28%, 13.79%, 10.17%, respectively) were significantly lower in group 1 compared to the other three groups (p < 0.05). The miscarriage rate was higher in patients with endometrial thickness less than 7 mm. The clinical pregnancy rate, ongoing pregnancy rate and implantation rate were highest in patients with endometrial thickness higher than 14 mm, but showed no difference in patients with those of endometrial thickness between 8-14 mm.

Conclusions: There is a correlation between endometrial thickness measured on hCG day and clinical outcome in normal responders with GnRH antagonist administration. The pregnancy rate was lower in patients with endometrial thickness less than 7 mm compared with patients with endometrial thickness more than 7 mm.

Figures

Figure 1
Figure 1
Clinical pregnancy rates according to endometrial thickness.

References

    1. Copperman AB, Benadiva C. Optimal usage of the GnRH antagonists: a review of the literature. Reprod Biol Endocrinol. 2013;11:20–32. doi: 10.1186/1477-7827-11-20.
    1. Tarlatzis BC, Fauser BC, Kolibianakis EM, Diedrich K, Rombauts L, Devroey P. GnRH antagonists in ovarian stimulation for IVF. Hum Reprod Update. 2006;12:333–340. doi: 10.1093/humupd/dml001.
    1. Qiao J, Lu G, Zhang HW, Chen H, Ma C, Olofsson JI, Witjes H, Heijnen E, Mannaerts B. A randomized controlled trial of the GnRH antagonist ganirelix in Chinese normal responders: high efficacy and pregnancy rates. Gynecol Endocrinol. 2012;28:800–804. doi: 10.3109/09513590.2012.665103.
    1. Al-Ghamdi A, Coskun S, Al-Hassan S, Al-Rejjal R, Awartani K. The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reprod Biol Endocrinol. 2008;6:37–41. doi: 10.1186/1477-7827-6-37.
    1. Kasius A, Smit JG, Torrance HL, Eijkemans MJ, Mol BW, Opmeer BC, Broekmans FJ. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod Update. 2014;20:530–534. doi: 10.1093/humupd/dmu011.
    1. Aydin T, Kara M, Turktekin N. Relationship between endometrial thickness and in vitro Fertilization/intracytoplasmicsperm injection outcome. Int J Fertil Steril. 2013;7:29–34.
    1. Kumbak B, Erden HF, Tosun S, Akbas H, Ulug U, Bahçeci M. Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm. Reprod Biomed Online. 2009;18:79–84. doi: 10.1016/S1472-6483(10)60428-2.
    1. Ferraretti AP1, La Marca A, Fauser BC, Tarlatzis B, Nargund G, Gianaroli L. ESHRE working group on Poor Ovarian Response Definition:ESHRE consensus on the definition of ‘poor response’ to ovarian stimulation for in vitro fertilization: the Bologna criteria. Hum Reprod. 2011;26:1616–1624. doi: 10.1093/humrep/der092.
    1. Friedler S, Schenker JG, Herman A, Lewin A. The role of ultrasonography in the evaluation of endometrial receptivity following assisted reproductive treatments: a critical review. Hum Reprod Update. 1996;2:323–335. doi: 10.1093/humupd/2.4.323.
    1. Detti L, Ambler DR, Yelian FD, Kruger ML, Diamond MP, Puscheck EE. Timing and duration of use of GnRH antagonist down-regulation for IVF/ICSI cycles have no impact on oocyte quality or pregnancy outcomes. J Assist Reprod Genet. 2008;25:177–181. doi: 10.1007/s10815-008-9217-2.
    1. Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol. 2001;18:258–263. doi: 10.1046/j.1469-0705.2001.00502.x.
    1. Yoeli R, Ashkenazi J, Orvieto R, Shelef M, Kaplan B, Bar-Hava I. Significance of increased endometrial thickness in assisted reproduction technology treatments. J Assist Reprod Genet. 2004;21:285–289. doi: 10.1023/B:JARG.0000043701.22835.56.
    1. Quintero RB1, Sharara FI, Milki AA. Successful pregnancies in the setting of exaggerated endometrial thickness. Fertil Steril. 2004;82:215–217. doi: 10.1016/j.fertnstert.2004.02.099.
    1. Al-Inany HG, Youssef MA, Aboulghar M, Broekmans F, Sterrenburg M, Smit J, Abou-Setta AM. Cochrane Database Syst Rev. 2011. Gonadotrophin-releasing hormone antagonists for assisted reproductive technology.
    1. Detti L, Yelian FD, Kruger ML, Diamond MP, Puscheck EE. Endometrial thickness dynamics and morphologic characteristics during pituitary downregulation with antagonists in assisted reproductive technology cycles. J Ultrasound Med. 2008;27:1591–1596.
    1. Giannaris D, Zourla A, Chrelias C, Loghis C, Kassanos D. Ultrasound assessment of endometrial thickness: correlation with ovarian stimulation and pregnancy rates in IVF cycles. Clin Exp Obstet Gynecol. 2008;35:190–193.
    1. Dekel N, Gnainsky Y, Granot I, Mor G. Inflammation and implantation. Am J Reprod Immunol. 2010;63:17–21. doi: 10.1111/j.1600-0897.2009.00792.x.

Source: PubMed

3
Abonnieren