Research question

Do uterine size parameters measured by baseline transvaginal ultrasound predict live birth after single embryo transfer (SET) of a high-quality blastocyst?

Design

Retrospective cohort study including women undergoing their first SET between August 2010 and March 2014 at a large university hospital reproductive centre. The effects of baseline uterine dimensions on live birth rate (LBR) were analysed while controlling for confounding effects.

Results

A total of 437 nulliparous and 70 parous women were included. The nulliparous group had lower body mass index (BMI) (24.4 ± 5.1 versus 25.9 ± 4.5 kg/m²; P = 0.015) and a higher number of fibroids (0.4 ± 1.0 versus 0.2 ± 0.5; P = 0.005) than the parous group. While controlling for confounding effects, none of the uterine parameters appeared to be a significant predictor of LBR among nulliparous and parous women (P > 0.05 in all cases). A subsequent analysis of endometrial length was done, whereby the endometrial lengths were divided into quartiles (20.0–32.2 mm; 32.3–36.5 mm; 36.6–40.0 mm; 40.1–54.0 mm). After controlling for confounders, the shortest quartile in the nulliparous group had a significantly lower LBR (P = 0.02) than the other groups. Receiver operating characteristic curves suggested that endometrial cavity length and cervical length did not aid clinically.

Conclusion

Uterine parameters do not have a clinically useful impact on LBR after SET of a blastocyst in infertile women. The use of baseline endometrial length to predict live birth is no better than chance, while cervical length only predicts failure to live birth.

中文翻译：

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子宫尺寸对不孕妇女单胚胎移植后活产率的影响。

研究问题

通过基线经阴道超声测量的子宫大小参数是否可以预测高质量囊胚单胚胎移植 (SET) 后的活产？

设计

回顾性队列研究包括在 2010 年 8 月至 2014 年 3 月期间在一家大型大学医院生殖中心接受第一次 SET 的女性。分析基线子宫尺寸对活产率 (LBR) 的影响，同时控制混杂效应。

结果

共包括 437 名未产妇和 70 名经产妇女。与经产组相比，未生育组的体重指数 (BMI) 较低（24.4 ± 5.1 对 25.9 ± 4.5 kg/m ²；P  = 0.015）和更多的肌瘤（0.4 ± 1.0 对 0.2 ± 0.5；P  = 0.005）团体。在控制混杂效应的同时，没有一个子宫参数似乎是未产妇和经产妇女 LBR 的重要预测因子（ 所有情况下P > 0.05）。随后对子宫内膜长度进行了分析，将子宫内膜长度分为四分位数（20.0-32.2 毫米；32.3-36.5 毫米；36.6-40.0 毫米；40.1-54.0 毫米）。控制混杂因素后，未生育组中最短四分位数的 LBR 显着降低（P = 0.02) 比其他组。接受者操作特征曲线表明子宫内膜腔长度和宫颈长度在临床上没有帮助。

结论

不孕女性囊胚 SET 后，子宫参数对 LBR 没有临床上有用的影响。使用基线子宫内膜长度来预测活产并不比机会好，而宫颈长度只能预测活产失败。