Abstract
Purpose
The aim of the systematic review is to describe the obstetrical complications associated with pregnancies in the context of a thin endometrial lining.
Methods
Systematic review of the literature.
Results
Patients who conceive in the setting of a thin endometrium have a significantly increased risk of early pregnancy loss, namely miscarriage and ectopic pregnancy. These patients also have a twofold increase in low birth weight and preterm delivery, as well as a significantly higher risk of intrauterine growth restriction and composite adverse perinatal outcomes.
Conclusions
In addition to the lower probability of conception, a thin endometrium in assisted reproductive technologies appears to be associated with both early and late pregnancy complications. These pregnancies thus warrant special attention and close follow-up from obstetricians.
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References
Kasius A, Smit JG, Torrance HL, Eijkemans MJC, Mol BW, Opmeer BC, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(4):530–41.
Yuan X, Saravelos SH, Wang Q, Xu Y, Li TC, Zhou C. Endometrial thickness as a predictor of pregnancy outcomes in 10787 fresh IVF-ICSI cycles. Reprod BioMed Online. 2016;33:197–205.
Sundström P. Establishment of a successful pregnancy following in-vitro fertilization with an endometrial thickness of no more than 4 mm. Hum Reprod. 1998;13(6):1550–2.
Check JH, Dietterich C, Check ML, Katz Y. Successful delivery despite conception with a maximal endometrial thickness of 4 mm. Clin Exp Obstet Gynecol. 2003;30(2–3):93–4.
Dix E, Check JH. Successful pregnancies following embryo transfer despite very thin late proliferative endometrium. Clin Exp Obstet Gynecol. 2010;37:15–6.
Qin JB, Sheng XQ, Wu D, Gao SY, You YP, Yang TB, et al. Worldwide prevalence of adverse pregnancy outcomes among singleton pregnancies after in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis. Arch Gynecol Obstet. 2017;295:285–301.
Burton GJ, Jauniaux E. The cytotrophoblastic shell and complications of pregnancy. Placenta. 2017;60:134–9.
Catt JW, Henman M. Toxic effects of oxygen on human embryo development. Hum Reprod. 2000;15:199–206.
Miwa I, Tamura H, Takasaki A, Yamagata Y, Shimamura K, Sugino N. Pathophysiologic features of “thin” endometrium. Fertil Steril. 2009;91(4):998–1004.
Chen S, Wu F, Lou C, Chen X, Shi X, et al. Combined analysis of endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer: a retrospective cohort study. Reprod Biol Endocrinol. 2010;8:30.
Yang W, Zhang T, Li Z, Ren X, Huang B, Zhu G, et al. Combined analysis of endometrial thickness and pattern in predicting clinical outcomes of frozen embryo transfer cycles with morphological good-quality blastocyst: a retrospective cohort study. Medicine. 2018;97(2):e9577.
Baradwan S, Shafi D, Baradwan A, Bashir MS, Al-Jaroudi D. The effect of endometrial thickness on pregnancy outcome in patients with Asherman’s syndrome post-hysteroscopic adhesiolysis. Int J Women’s Health. 2018;10:77–82.
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.
Chung K, Coutifaris C, Chalian R, Lin K, Ratcliffe S, Castelbaum A, et al. Factors influencing adverse perinatal outcomes in pregnancies achieved through use of in vitro fertilization. Fertil Steril. 2006;86:1634–41.
Moffat R, Beutler S, Schötzau A, De Geyter M, De Geyter C. Endoemtrial thickness influences neonatal birth weight in pregnancies with obstetric complications achieved after fresh IVF/ICSI cycles. Arch Gynecol Obstet. 2017;296:115–22.
Spandorfer S, Barnhart K. Endometrial stripe thickness as a predictor of ectopic pregnancy. Fertil Steril. 1996;66:474–7.
Juneau CR, Franasiak JM, Morin SJ, Molinaro TA, Scott RT. Obstetric outcomes following frozen embryo transfer (FET) in patients with an endometrial thickness measuring < 7mm. [Abstract]. ASRM. 2016;106(3):e214.
Mouhayar Y, Sharara FI. Modern management of thin lining. Middle East Fertil Soc J. 2017;20:1–12.
Mouhayar Y, Sharara FI. G-CSF and stem cell therapy for the treatment of refractory thin lining in assisted reproductive technology. J Assist Reprod Genet. 2017;34:831–7.
De Geyter C, De Geyter M, Steimann S, Zhang H, Holzgreve W. Comparative birth weights of singletons born after assisted reproduction and natural conception in previously infertile women. Hum Reprod. 2006;21:705–12.
Nakashima A, Araki R, Tani H, Ishihara O, Kuwahara A, Irahara M, et al. Implications of assisted reproductive technologies on term singleton birth weight: an analysis of 25,777 children in the national reproduction registry of Japan. Fertil Steril. 2013;99:450–5.
Ectopic pregnancy—United States, 1990–1992. Centers for Disease Control and Prevention (CDC). MMWR Morb Mortal Wkly Rep. 1995;44:46–8.
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Mouhayar, Y., Franasiak, J.M. & Sharara, F.I. Obstetrical complications of thin endometrium in assisted reproductive technologies: a systematic review. J Assist Reprod Genet 36, 607–611 (2019). https://doi.org/10.1007/s10815-019-01407-y
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DOI: https://doi.org/10.1007/s10815-019-01407-y