Skip to main content
SpringerLink
Log in

Can endometrial compaction predict live birth rates in assisted reproductive technology cycles? A systematic review and meta-analysis

  • Review
  • Published:
Journal of Assisted Reproduction and Genetics Aims and scope Submit manuscript

Abstract

Purpose

Endometrial compaction (EC) is defined as the difference in endometrial thickness from the end of the follicular phase to the day of embryo transfer (ET). We aimed to determine the role of EC in predicting assisted reproductive technology (ART) success by conducting a meta-analysis of studies reporting the association between EC and clinical outcomes of ART.

Methods

MEDLINE via PubMed, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from the date of inception to May 19, 2023. The primary outcome was live birth rate (LBR) per ET. Secondary outcomes were live birth or ongoing pregnancy per ET, ongoing pregnancy per ET, clinical pregnancy per ET, and miscarriage per clinical pregnancy.

Results

Fifteen studies were included. When data from all studies reporting live birth were pooled, overall LBR rates were comparable in cycles showing EC or not [RR = 0.97, 95%CI = 0.92 to 1.02; 10 studies, 11,710 transfer cycles]. In a subgroup of studies that included euploid ET cycles, a similar LBR for patients with and without EC was noted [RR = 0.99, 95%CI = 0.86 to 1.13, 4 studies, 1172 cycles]. The miscarriage rate did not seem to be affected by the presence or absence of EC [RR = 1.06, 95%CI = 0.90 to 1.24; 12 studies].

Conclusion

The predictive value of EC in determining LBR is limited, and assessment of EC may no longer be necessary, given these findings.

Trial registration

PROSPERO CRD42023410389

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Crosby DA, Glover LE, Downey P, Mooney EE, McAuliffe FM, O'Farrelly C, et al. Mid-luteal uterine artery Doppler indices in the prediction of pregnancy outcome in nulliparous women undergoing assisted reproduction. Hum Fertil (Camb). 2022;25(4):670–6.

    Article  CAS  PubMed  Google Scholar 

  2. Martins RS, Oliani AH, Oliani DV, de Oliveira JM. Continuous endometrial volumetric analysis for endometrial receptivity assessment on assisted reproductive technology cycles. BMC Pregnancy Childbirth. 2020;20(1):663.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Zhang CH, Chen C, Wang JR, Wang Y, Wen SX, Cao YP, et al. An endometrial receptivity scoring system basing on the endometrial thickness, volume, echo, peristalsis, and blood flow evaluated by ultrasonography. Front Endocrinol (Lausanne). 2022;13:907874.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Liu KE, Hartman M, Hartman A, Luo ZC, Mahutte N. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: an analysis of over 40 000 embryo transfers. Hum Reprod. 2018;33(10):1883–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Mahutte N, Hartman M, Meng L, Lanes A, Luo ZC, Liu KE. Optimal endometrial thickness in fresh and frozen-thaw in vitro fertilization cycles: an analysis of live birth rates from 96,000 autologous embryo transfers. Fertil Steril. 2022;117(4):792–800.

    Article  PubMed  Google Scholar 

  6. Shakerian B, Turkgeldi E, Yildiz S, Keles I, Ata B. Endometrial thickness is not predictive for live birth after embryo transfer, even without a cutoff. Fertil Steril. 2021;116(1):130–7.

    Article  CAS  PubMed  Google Scholar 

  7. Ata B, Liñán A, Kalafat E, Ruíz F, Melado L, Bayram A, et al. Effect of endometrial thickness on live birth rate - insights from 959 single euploid frozen embryo transfers without a cut-off for thickness. Fertil Steril. 2023;120(1):91–98.

  8. Shah JS, Vaughan DA, Dodge LE, Leung A, Korkidakis A, Sakkas D, et al. Endometrial compaction does not predict live birth in single euploid frozen embryo transfers: a prospective study. Hum Reprod. 2022;37(5):980–7.

    Article  CAS  PubMed  Google Scholar 

  9. Youngster M, Mor M, Kedem A, Gat I, Yerushalmi G, Gidoni Y, et al. Endometrial compaction is associated with increased clinical and ongoing pregnancy rates in unstimulated natural cycle frozen embryo transfers: a prospective cohort study. J Assist Reprod Genet. 2022;39(8):1909–16.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Haas J, Smith R, Zilberberg E, Nayot D, Meriano J, Barzilay E, et al. Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers. Fertil Steril. 2019;112(3):503–9.e1.

    Article  CAS  PubMed  Google Scholar 

  11. Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound Obstet Gynecol. 2001;18(3):258–63.

    Article  CAS  PubMed  Google Scholar 

  12. Huang J, Lin J, Gao H, Zhu J, Lu X, Song N, et al. Value of endometrial thickness change after human chorionic gonadotrophin administration in predicting pregnancy outcome following fresh transfer in vitro fertilization cycles. Arch Gynecol Obstet. 2020;303(2):565–72.

    Article  PubMed  Google Scholar 

  13. Lam MT, Li HWR, Ng EHY. Impact of endometrial thickness and volume compaction on the live birth rate following fresh embryo transfer of in vitro fertilization. J Ultrasound Med. 2022;41(6):1455–63.

    Article  PubMed  Google Scholar 

  14. Yaprak E, Şükür YE, Özmen B, Sönmezer M, Berker B, Atabekoğlu C, et al. Endometrial compaction is associated with the increased live birth rate in artificial frozen-thawed embryo transfer cycles. Hum Fertil (Camb). 2021;18:1–7.

  15. Zilberberg E, Smith R, Nayot D, Haas J, Meriano J, Barzilay E, et al. Endometrial compaction before frozen euploid embryo transfer improves ongoing pregnancy rates. Fertil Steril. 2020;113(5):990–5.

    Article  CAS  PubMed  Google Scholar 

  16. Gill P, Melamed N, Barrett J, Casper RF. A decrease in endometrial thickness before embryo transfer is not associated with preterm birth and placenta-mediated pregnancy complications. Reprod Biomed Online. 2023;46(2):283–8.

    Article  CAS  PubMed  Google Scholar 

  17. Li Q, Liu A, Shen H, Zhang X. Endometrial compaction after human chorionic gonadotrophin administration reduces ectopic pregnancy rate following fresh embryo transfer in vitro fertilization/intracytoplasmic sperm injection cycles in patients with non-thin endometrium: a retrospective cohort study. Reprod Biol Endocrinol. 2022;20(1):151.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Babayev E, Matevossian K, Hensley C, Zhang JX, Bulun SE. Baseline endometrial thickness or endometrial thickness change in response to estrogen is not predictive of frozen embryo transfer success in medicated cycles. Reprod Sci. 2020;27(12):2242–6.

    Article  CAS  PubMed  Google Scholar 

  19. Bu Z, Yang X, Song L, Kang B, Sun Y. The impact of endometrial thickness change after progesterone administration on pregnancy outcome in patients transferred with single frozen-thawed blastocyst. Reprod Biol Endocrinol. 2019;17(1):99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Barker MA, Boehnlein LM, Kovacs P, Lindheim SR. Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles. J Assist Reprod Genet. 2009;26(5):243–9.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Gursu T, Goksever Celik H, Eraslan A, Angun B, Ozaltin S, Yeh J, et al. Impact of endometrial thickness change in response to progesterone on live birth rates embryo transfers with fresh oocyte donation cycles. J Obstet Gynaecol. 2022;42(7):3260–7.

    Article  CAS  PubMed  Google Scholar 

  22. Jin Z, Li J, Yang E, Shi H, Bu Z, Niu W, et al. Effect of endometrial thickness changes on clinical pregnancy rates after progesterone administration in a single frozen-thawed euploid blastocyst transfer cycle using natural cycles with luteal support for PGT-SR- and PGT-M-assisted reproduction: a retrospective cohort study. Reprod Biol Endocrinol. 2021;19(1):154.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Jin Z, Shi H, Lu M, Bu Z, Huo M, Zhang Y. Endometrial thickness changes after progesterone administration do not affect the pregnancy outcomes of frozen-thawed euploid blastocyst transfer: a retrospective cohort study. Fertil Steril. 2021;116(6):1502–12.

    Article  CAS  PubMed  Google Scholar 

  24. Kaye L, Rasouli MA, Liu A, Raman A, Bedient C, Garner FC, et al. The change in endometrial thickness following progesterone exposure correlates with in vitro fertilization outcome after transfer of vitrified-warmed blastocysts. J Assist Reprod Genet. 2021;38(11):2947–53.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Ye J, Zhang J, Gao H, Zhu Y, Wang Y, Cai R, et al. Effect of endometrial thickness change in response to progesterone administration on pregnancy outcomes in frozen-thawed embryo transfer: analysis of 4465 cycles. Front Endocrinol (Lausanne). 2020;11:546232.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Huang J, Lin J, Cai R, Lu X, Song N, Gao H, et al. Significance of endometrial thickness change after human chorionic gonadotrophin triggering in modified natural cycles for frozen-thawed embryo transfer. Ann Transl Med. 2020;8(23):1590.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Olgan S, Dirican EK, Sakinci M, Caglar M, Ozsipahi AC, Gul SM, et al. Endometrial compaction does not predict the reproductive outcome after vitrified-warmed embryo transfer: a prospective cohort study. Reprod Biomed Online. 2022;45(1):81–7.

    Article  PubMed  Google Scholar 

  28. Riestenberg C, Quinn M, Akopians A, Danzer H, Surrey M, Ghadir S, et al. Endometrial compaction does not predict live birth rate in single euploid frozen embryo transfer cycles. J Assist Reprod Genet. 2021;38(2):407–12.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Fleischer AC, Pittaway DE, Beard LA, Thieme GA, Bundy AL, James AE Jr, et al. Sonographic depiction of endometrial changes occurring with ovulation induction. J Ultrasound Med. 1984;3(8):341–6.

    Article  CAS  PubMed  Google Scholar 

  30. Tabibzadeh S. Proliferative activity of lymphoid cells in human endometrium throughout the menstrual cycle. J Clin Endocrinol Metab. 1990;70(2):437–43.

    Article  CAS  PubMed  Google Scholar 

  31. Usadi RS, Groll JM, Lessey BA, Lininger RA, Zaino RJ, Fritz MA, et al. Endometrial development and function in experimentally induced luteal phase deficiency. J Clin Endocrinol Metab. 2008;93(10):4058–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  32. De Geyter C, Schmitter M, De Geyter M, Nieschlag E, Holzgreve W, Schneider HPG. Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1,186 infertile women. Fertil Steril. 2000;73(1):106–13.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

We want to thank Jaimin S. Shah MD, Laura E. Dodge Sc.D./MPH, and their team for kindly sharing their data upon request.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Koc University, Istanbul, Turkey

    E. Turkgeldi, S Yildiz, E. Kalafat, B. Ata & G. Bozdag

  2. Koc University Hospital, Assisted Reproduction Unit, Istanbul, Turkey

    I. Keles

  3. ART Fertility Center, Dubai, UAE

    B. Ata

Authors
  1. E. Turkgeldi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Yildiz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Kalafat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. I. Keles
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B. Ata
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. G. Bozdag
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

ET participated in study design, literature search, data extraction, data analysis, drafting of the manuscript, and critical revision of the manuscript.

SY participated in the literature search, data extraction, data analysis, and critical revision of the manuscript.

EK participated in the literature search, quality assessment, and critical revision of the manuscript.

IK participated in the quality assessment and critical revision of the manuscript.

BA participated in the drafting and critical revision of the manuscript.

GB participated in the study concept and design, drafting of the manuscript, and critical revision of the manuscript.

Corresponding author

Correspondence to E. Turkgeldi.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Turkgeldi, E., Yildiz, S., Kalafat, E. et al. Can endometrial compaction predict live birth rates in assisted reproductive technology cycles? A systematic review and meta-analysis. J Assist Reprod Genet 40, 2513–2522 (2023). https://doi.org/10.1007/s10815-023-02942-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10815-023-02942-5

Keywords

Search

Navigation