Abstract
BackgroundThe aim of this study was to explore the impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst.MethodsThis observational cohort study included a total of 3091 patients undergoing their first frozen-thawed embryo transfer (FET) cycles between April 2015 to March 2019. Endometrial thickness was measured by trans-vaginal ultrasound twice for each patient: on day of progesterone administration, and on day of embryo transfer. The change of endometrial thickness was recorded.ResultsRegardless of endometrial preparation protocol (estrogen-progesterone/natural cycle), female age, body mass index (BMI), and infertility diagnosis were comparable between patients with an increasing endometrium on day of embryo transfer and those without. However, clinical pregnancy rate increases with increasing ratio of endometrial thickness. Compared with patients with Non-increase endometrium, those with an increasing endometrium on day of embryo transfer resulted in significantly higher clinical pregnancy rate (56.21% vs 47.13%, P = 0.00 in estrogen-progesterone cycle; 55.15% vs 49.55%, P = 0.00 in natural cycle).ConclusionsIn most patients, endometrial thickness on day of embryo transfer (after progesterone administration) increased or kept being stable compared with that on day of progesterone administration. An increased endometrium after progesterone administration was associated with better pregnancy outcome.
Highlights
The debate about the relationship between endometrial thickness and clinical pregnancy has never stopped [1, 2]
Most studies have observed that thin endometrium has an adverse effect on pregnancy outcome during in vitro fertilization (IVF) treatment, even though the specific mechanism is not well understood [3,4,5]
Why scholars are keen to study the relationship between endometrium and pregnancy outcome? One of the important reasons is that endometrial thickness may represent endometrial receptivity [6]
Summary
The debate about the relationship between endometrial thickness and clinical pregnancy has never stopped [1, 2]. One of the important reasons is that endometrial thickness may represent endometrial receptivity [6]. Endometrial receptivity mainly refers to the ability of the endometrium to accept embryos when implantation window is open, which is around 7 days after ovulation in natural menstrual cycle. In patients undergoing IVF treatment, the day of embryo transfer is usually considered to be in the middle of implantation window. The aim of this study was to explore the impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst
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