Predictive value of D-dimer in patients with unexplained recurrent implantation failure during freeze-thaw embryo transfer cycles.

Abstract

This study aimed to evaluate whether D-dimer can predict the clinical outcomes of patients with unexplained recurrent implantation failure (URIF) during freeze-thaw embryo transfer (FET) cycles. Our study was divided into two parts. The first part was a retrospective study that included 433 patients. Plasma D-dimer levels were monitored in all patients before FET, and the patients were classified into two groups according to whether they delivered at least one live infant or not. D-dimer was compared between groups, and receiver operating characteristic (ROC) curves were constructed to analyze the impact of D-dimer on live birth. The second part was a prospective study that included 113 patients who were categorized into high and low D-dimer groups based on the ROC curve analysis from the retrospective study. Clinical outcomes were compared between these two groups. In the first part, we found that plasma D-dimer levels in patients with live birth were significantly lower than those in patients without live birth. According to the ROC curve, 0.22mg/L was the cutoff value for D-dimer in the prediction of the live birth rate (LBR) (AUC 0.806, 95% CI: 0.763, 0.848). The second part of the study confirmed that clinical pregnancy rate (50.98%vs. 32.26%, P=.044) and LBR (41.18%vs. 22.58%, P=.033) of patients with D-dimer ≤0.22mg/L were all significantly higher than those of patients with D-dimer>0.22mg/L. Our study indicates that D-dimer>0.22mg/L is a useful index for predicting URIF during FET cycles.