IVF with ICSI: endometrial thickness predicts live birth rate

  • Song J & al.
  • Reprod Sci
  • 3 Dec 2018

  • curated by Brian Richardson, PhD
  • Clinical Essentials
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Takeaway

  • Endometrial response is associated with live birth rate in women undergoing in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).
  • Prolonged pituitary downregulation with gonadotropin-releasing hormone agonist (GnRH-a) improves outcomes in patients with thin/medium endometrium.

Why this matters

  • Study seeks to clarify the relationship between ovarian response, endometrial thickness, and IVF outcomes.

Key results

  • Estradiol levels were not significantly associated with the live birth rate (P>.05).
  • Endometrial thickness was independently associated with live birth rate (OR, 0.889; P<.001>
  • Compared with a short GnRH-a long protocol, the prolonged protocol was associated with higher implantation rates and clinical pregnancy rates in women with medium/thin endometrium.
    • Implantation rates: 43.7% vs 53.7% (P=.000) for >10 to 7 to ≤10 mm, and 5.0% vs 28.6% (P=.016) for ≤7 mm.
    • Clinical pregnancy rates: 58.6% vs 68.3% (P=.000) for >10 to 7 to ≤10 mm, and 9.1% vs 36.0% (P=.030) for ≤7 mm.

Study design

  • 9511 patients age ≤35 years who underwent IVF/ICSI, 7665 who underwent short GnRH-a long protocol, and 1846 who underwent GnRH-a prolonged protocol were analyzed for association between estradiol levels, endometrial thickness, treatment duration, and outcomes.
  • Funding: National Natural Science Foundation of China.

Limitations

  • Retrospective.

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