Abstract
Introduction The acceptable lower limit for the endometrial thickness (EMT) and the subsequent successful outcome of the treatment by assisted reproductive techniques (ART) is considered to be 8 mm. There is a practical possibility to influence the EMT and submucosal vascularity with exogenous estrogens, vasodilatative and antiaggregant medications, local injury, intrauterine application of platelet-rich plasma and etc. The study aim is to check the association between EMT on the day of embryotransfer (ET) with better IVF outcomes. Material and Methods The data is from a cohort study conducted by the IVF unit of “Dr. Shterev” Hospital. To assess the predictive value of the EMT an ultrasound measurement has been performed on 370 women who have undergone controlled ovarian hyperstimulation for IVF/ICSI. The mean duration of infertility in the couples before starting treatment is 5 years and 4 months (SD ± 3.09). The mean age of all women included in the study is 32.13 years (SD ± 4.78). The majority of cases we have found primary infertility (61.14%) compared to those with secondary infertility (38.86%). The evaluation of the EMT on the day of ET is performed by a trans-vaginal ultrasound image of the uterus in longitudinal scan. Results We found a statistically insignificant tendency to increase the diameter (by 0.22 mm) of the EMT in the group of pregnant women: - pregnant group 84/370 - EMT = 11.30 mm; - non-pregnant group 286/370 - EMT = 11.08 mm. Interesting relationships were found in the group with established clinical pregnancy after ET. The most unfavorable are the ectopic pregnancy conditions (EMT Conclusion The assessment of the EMT is a recommended approach and can be used as a prognostic indicator for the ART outcome but not alone because there is a statistically insignificant (p > 0.05) poor relationship between EMT and the progression of pregnancy. Future studies are needed to take into account the independence of the uterine factor. Additional data from a detailed endometrial investigations such as volume, blood supply, expression of certain receptors and genes will give guidance in the treatment of patients with recurrent implantation failures.
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