O-024 Age affects ultrasound markers of endometrial receptivity in artificial cycles

Abstract

Abstract Study question Are ultrasound markers of endometrial receptivity affected by patient age in artificial cycles? Summary answer Maternal age is linked to certain ultrasound markers such as a larger uterus, reduced endometrial compaction and lower uterine peristalsis. What is known already The decline in fertility in advanced age women has traditionally been linked to low oocyte quantity and quality. However, recent studies indicate that age may also affect endometrial aspects, influencing implantation and live birth rates. Advanced age can lead to impaired decidualization, increased fibrosis and decreased expression of progesterone and estradiol receptors. This study aims to investigate the influence of age on ultrasound factors related to implantation in patients undergoing embryo transfer in artificial cycles. Study design, size, duration Retrospective study of 452 patients undergoing frozen embryo transfer with artificial cycle, between January 2017 and December 2023. Participants/materials, setting, methods Ultrasound markers were evaluated, including assessment of uterine pathology, endometrial thickness before and after the onset of progesterone and uterine peristalsis. Serum progesterone level was also analysed. Spearman correlation and multivariate linear regression were used for analysis, adjusting for uterine factors. Subgroup analysis was performed for patients aged ≥45 years. Main results and the role of chance Age correlated inversely with endometrial compaction (S range: 0.3–0.2; p = 0.01) and uterine peristalsis (S range: −0.3–0.1; p < 0.001) and positively with uterus length (S range: 0.2–0.3; p < 0.001) and fibroids. Multivariate linear regression confirmed independent associations (R=.45; p < 0.001). Logistic regression in patients aged ≥45 revealed associations with uterine peristalsis (OR 0.7, 95%CI 0.5–0.9; p = 0.04) and uterus length (OR 1.03; 95%CI 1.01-1.06) but not with endometrial compaction (p = 0.103). Limitations, reasons for caution The main limitation of the study is its retrospective nature. Being a study based on daily clinical practice, the group of patients can be heterogeneous, which may have influenced the results. Studies with a homogeneous control group are needed to corroborate our findings. Wider implications of the findings Our findings indicate that advanced maternal age affects uterine ultrasound factors, potentially influencing endometrial receptivity in artificial treatments. This may be useful to inform patients of their prognosis and to perform better clinical counseling, as well as to explore different therapeutic strategies in older patients. Trial registration number not applicable