Influence of endometrial thickness on the outcome of spontaneous abortion in IVF-ET cycle and threshold effect analysis
10.3760/cma.j.cn101441-20220322-00126
- VernacularTitle:子宫内膜厚度对IVF-ET助孕患者早期自然流产结局的影响及阈值效应分析
- Author:
Tiantian CHENG
1
;
Jingjing FAN
1
;
Fang YUAN
1
;
Hua ZHAO
1
;
Lan YU
1
;
Cuilian ZHANG
1
;
Qiaohua HE
1
Author Information
1. 河南大学人民医院 河南省人民医院 郑州大学人民医院生殖中心，郑州 450003
- Publication Type:Journal Article
- Keywords:
Abortions, spontaneous;
Fertilization in vitro;
Blastocyst;
Endometrium;
Embryo
- From:
Chinese Journal of Reproduction and Contraception
2023;43(7):676-682
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the relationship between endometrial thickness (EMT) at the time of human chorionic gonadotropin (hCG) trigger day or endometrial transformation day and spontaneous abortion in in vitro fertilization (IVF) cycle and analyze the threshold effect. Methods:A retrospective cohort study was performed to analyze the clinical data of infertile patients who underwent the first IVF cycle in the Reproductive Center of Henan Provincial People's Hospital from January 2010 to December 2018. The patients were divided into four groups according to EMT, group A: EMT<8 mm, group B: 8 mm≤EMT<10 mm, group C: 10 mm≤EMT<12 mm, and group D: EMT≥12 mm. The effect of EMT on spontaneous abortion rate during IVF cycle was investigated by univariate analysis, multivariate logistic regression analysis, smooth curve fitting and the threshold effect analysis.Results:In all 12 912 IVF cycles, 8 674 cycles got clinical pregnancy, 1 102 cycles resulted in early spontaneous miscarriage and the spontaneous abortion rate was 12.70%. Univariate regression analysis showed that age, body mass index, duration of infertility, type of infertility, male factors in infertility factors, No. of spontaneous abortions, EMT and No. of embryos transferred had influences on the spontaneous abortion rate (all P<0.05). Multivariate logistic regression analysis adjusted for confounding factors and group A was used as control group. The results showed that the spontaneous abortion rate of groups B, C and D was significantly lower than that of group A during embryo transfer at cleavage stage ( P=0.008 , P<0.001, P<0.001); there was no significant difference in spontaneous abortion rate with the increase of EMT during blastocyst stage ( P>0.05). The threshold effect analysis showed that when the EMT was <10.3 mm, the spontaneous abortion rate decreased significantly with the increasing of EMT for cleavage embryo, and the spontaneous abortion rate decreased 14.7% with each 1 mm increment in EMT ( OR=0.853, 95% CI: 0.792-0.918, P<0.001); there was no significant difference in spontaneous abortion rate when EMT was ≥10.3 mm ( OR=1.006, 95% CI: 0.959-1.056, P=0.798). The spontaneous abortion rate changed steadily with the increase of EMT, and the difference was not statistically significant for blastocyst embryo ( P>0.05). Conclusion:In IVF cycle, the relationship between EMT and spontaneous abortion was curvilinear for cleavage embryo. Before the EMT reached the threshold of 10.3 mm, the spontaneous abortion rate decreased significantly with the increase of EMT.
