Research question

What is the association of the entire range of trigger-day endometrial thickness (EMT) with live birth rate (LBR) after IVF and fresh embryo transfer? Although EMT is amenable to convenient non-invasive routine measurement, studies of the association between pre-trigger EMT and assisted reproductive technology outcome have yielded equivocal results.

Design

A cohort of IVF fresh day-3 embryo transfers in patients aged 42 years and younger in a single centre between 2009 and 2017. The LBR was calculated for all trigger-day EMT values, stratified into five groups overall and within subgroups of patient age and ovarian response. Univariate analysis and multivariate logistic regression models were used to compare the LBRs at different EMT measurements adjusting for various independent variables.

Results

A total of 5133 cycles were included. The LBRs were as follows: 11.22% (35/312) in cycles with EMT 6 mm or less, 17.98% (380/2114) in cycles with EMT 7–9 mm, 23.44% (476/2031) in cycles with EMT 10–12 mm, 25.62% (144/562) in cycles with EMT 13–15 mm and 34.21% (39/114) in cycles with EMT 16 mm or more (P < 0.001). Similar findings were observed by patient age and ovarian response. The observation was confirmed by multivariate logistic regression analysis in which the EMT was found to be a significant independent predictor of LBR even after controlling for various confounders (OR 0.935, 95% CI 0.908 to 0.962; P < 0.001).

Conclusions

Pre-trigger EMT is in significant independent correlation with LBR, even after adjusting for age and ovarian response. Maximal endometrial proliferation is beneficial, and fresh embryo transfer can be carried out at high EMT values without endangering the outcome of the cycle.

中文翻译：

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新鲜IVF周期中触发日子宫内膜厚度的整个范围与活产率独立相关。

研究问题

IVF和新鲜胚胎移植后，整个触发天子宫内膜厚度（EMT）范围与活产率（LBR）有什么关联？尽管EMT可以方便地进行非侵入式常规测量，但是对触发前EMT与辅助生殖技术成果之间关系的研究却产生了模棱两可的结果。

设计

在2009年至2017年之间，在同一中心的42岁及以下的42岁及以下患者中进行了IVF新鲜3天胚胎移植。对所有触发日EMT值进行了LBR计算，分为总体五个组，在患者年龄和卵巢反应。单变量分析和多元逻辑回归模型用于比较在调整各种自变量的不同EMT测量值下的LBR。

结果

总共包括5133个循环。LBR如下：在EMT为6mm或更小的情况下，周期为11.22％（35/312），在EMT为7-9mm的情况下，周期为17.98％（380/2114），在EMT 10情况下，为23.44％（476/2031）使用EMT 13–15 mm时，周期为–12 mm，25.62％（144/562），使用EMT 16 mm或以上时，周期为34.21％（39/114）（P <0.001）。通过患者年龄和卵巢反应观察到相似的发现。多元逻辑回归分析证实了这一观察结果，其中即使在控制了各种混杂因素后，EMT仍是LBR的重要独立预测因子（OR 0.935，95％CI 0.908至0.962；P <0.001）。

结论

即使调整了年龄和卵巢反应，触发前EMT与LBR仍具有显着的独立相关性。最大的子宫内膜增生是有益的，并且可以在高EMT值下进行新鲜的胚胎移植，而不会危及该周期的结果。