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Increasing Endometrial Thickness Beyond 8 mm Does Not Alter Clinical Pregnancy Rate After Single Euploid Embryo Transfer

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Abstract

The aim of this study was to investigate if variation in endometrial thickness affects clinical pregnancy and live birth rates among patients undergoing single euploid embryo transfer (SET). A retrospective review of IVF cycles performed at a single private fertility institution between 2015 and 2020 was performed. Patients with normal uterine anatomy undergoing their first SET of a euploid embryo undergoing their first cycle at the center were included, for a total of 796 cycles. Endometrial thickness was measured by transvaginal ultrasound following 10–14 days of estradiol exposure. Specific infertility diagnoses did not significantly impact endometrial lining thickness with means across diagnoses ranging from 9.3 to 11.0 mm. Endometrial thickness was grouped into five categories: < 8 mm, 8–10 mm, 10–13 mm, 13–15 mm, and ≥ 15 mm. Using 8–10 mm as the reference group, the odds ratio of live birth was 0.5, 1.22, 1.05, and 1.05 for < 8 mm, 10–13 mm, 13–15 mm, and ≥ 15 mm groups, respectively. Risk of first trimester miscarriage was equivalent across groups. There was a trend toward an increased rate of biochemical pregnancies in patients with a < 8 mm and ≥ 15 mm endometrium; however, this was not statistically significant. The clinical pregnancy and live birth rate were lowest in patients with < 8-mm endometrial thickness. For single euploid embryo transfers, an endometrial lining greater than or equal to 8 mm confers optimal live birth rates following a medicated FET cycle. These data confirm the findings of prior studies in fresh embryo transfers without the confounders of supraphysiologic ovarian hormone concentrations and genetically untested embryos.

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Funding

K.T. was supported by NIH grant P30 CA77598 utilizing the Biostatistics Core shared resource of the Masonic Cancer Center, University of Minnesota and by the National Center for Advancing Translational Sciences of the National Institutes of Health Award Number UL1TR002494.

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Author notes

  1. Stephanie Dahl and April Batcheller contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics, Gynecology, and Women’s Health, Division of Reproductive Endocrinology and Infertility, University of Vermont, Burlington, VT, USA

    Tia Y. Brodeur & Navid Esfandiari

  2. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Indiana University, Indianapolis, IN, USA

    Tia Y. Brodeur

  3. CCRM Minneapolis, Minneapolis, MN, USA

    Brent Hanson, Stephanie Dahl & April Batcheller

  4. Department of Obstetrics, Gynecology, and Women’s Health, University of Minnesota, Minneapolis, MN, USA

    Navin N. Maredia, Katelyn M. Tessier, Stephanie Dahl & April Batcheller

  5. Masonic Cancer Center, Biostatistics Core, University of Minnesota, Minneapolis, Minnesota, USA

    Katelyn M. Tessier

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  1. Tia Y. Brodeur
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  2. Brent Hanson
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  3. Navin N. Maredia
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  4. Katelyn M. Tessier
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  5. Navid Esfandiari
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  6. Stephanie Dahl
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  7. April Batcheller
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Correspondence to Tia Y. Brodeur.

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Brodeur, T.Y., Hanson, B., Maredia, N.N. et al. Increasing Endometrial Thickness Beyond 8 mm Does Not Alter Clinical Pregnancy Rate After Single Euploid Embryo Transfer. Reprod. Sci. 31, 1045–1052 (2024). https://doi.org/10.1007/s43032-023-01385-8

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