The results of assisted reproductive technology programs in patients with “thin” endometrium

Abstract

Relevance. Effectiveness of assisted reproductive technology (ART) programs is quite high, but for couples who have already had failed attempts of ART programs the likelihood of getting pregnant decreases with each subsequent attempt. Low endometrial thickness is a common cause of a decline in a possibility of getting pregnant. However, data on predictive value of this index in ART programs are contradictory. Some researchers do not find a correlation between the endometrium thickness and ART programs outcomes. Other researchers revealed a statistically significant relationship between endometrium thickness and pregnancy rate in ART cycles. Aim. To evaluate an effect of “thin” endometrium on pregnancy rate in ART programs. Materials and methods. 154 couples who applied for infertility treatment in ART programs were included in this prospective study. The patients were stratified into groups depending on whether a pregnancy to occur: Group 1 (n=43) - pregnancy occurred and Group 2 (n=111) - pregnancy did not occur. Then the endometrial thickness threshold determining pregnancy occurrence was identified by ultrasound and two additional groups were formed: Group 3 (n=85) - patients with “thin” endometrium, Group 4 (n=69) - patients with normal endometrial thickness. Results. The endometrial thickness threshold at which pregnancy probability, as well as the model and area under the curve (AUC) reliability were maximum, was 8.0 mm (AUC=86.7%, sensitivity - 97.7%, specificity - 75.7%). The adjusted odds ratio of pregnancy occurrence depending on endometrial thickness given the excellent quality blastocysts obtained, was 9.1 (95% confidence interval 4.3-19.3). Factors affecting endometrial thickness were endometrial polyps with polypectomy and spontaneous miscarriages in anamnesis that was undoubtedly associated with an inflammatory genesis of endometrial damage Conclusions. "Thin" endometrium plays a negative role in ART programs reducing pregnancy likelihood by 9.1 times.