Abstract
There is some consensus that endometrial thickness (EMT) needs to be at least 7 mm on day of embryo transfer. However, the predictive role of baseline EMT and EMT change in response to estrogen is largely unknown. The objective of this study was to evaluate the role of endometrial thickness in frozen embryo transfer (FET) cycles. We analyzed the association of baseline endometrial thickness (EMTb—Day 3 of cycle) and endometrial thickness change (EMTΔ—from baseline to start of progesterone supplementation) with FET success in 121 cycles. We also investigated whether baseline estradiol levels and body mass index (BMI) are associated with EMTb. No difference was observed in EMTb and EMTΔ in cycles resulting in clinical pregnancy compared to unsuccessful transfers (5.1 ± 2.2 mm vs 5.0 ± 1.9 mm; p = 0.92, and 4.7 ± 2.4 mm vs. 4.4 ± 2.4 mm; p = 0.56). When 7 mm cut-off was used, endometrial thickness on the day of start of progesterone supplementation (EMTp) was also not different between groups (9.8 ± 2.9 mm vs. 9.4 ± 2.5 mm; p = 0.50). Multivariable logistic regression models did not demonstrate any predictive value of EMTb, EMTp, or EMTΔ in predicting success of FET cycles (p = 0.92, p = 0.80, and p = 0.84, respectively). There was no significant correlation between EMTb and baseline estradiol levels (r = −0.001; p = 0.985). BMI showed statistically significant weak positive linear relationship with EMTb (r = +0.29; p = 0.002). Our study did not demonstrate any significant relationship between baseline endometrial thickness or endometrial thickness change and clinical pregnancy rates in frozen embryo transfer cycles. Significant positive linear relationship of BMI with baseline endometrial thickness, despite no correlation between baseline estradiol and EMTb, points to the role of possible other mechanism affecting EMT besides estradiol in obese patients.
Similar content being viewed by others
References
Wright VC, Chang J, Jeng G, Macaluso M. Assisted reproductive technology surveillance—United States, 2005. MMWR Surveill Summ. 2008;57:1–23.
Kasius A, Smit JG, Torrance HL, Eijkemans MJ, Mol BW, Opmeer BC, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod Update. 2014;20:530–41.
Harton GL, Munné S, Surrey M, Grifo J, Kaplan B, McCulloh DH, et al. Diminished effect of maternal age on implantation after preimplantation genetic diagnosis with array comparative genomic hybridization. Fertil Steril. 2013;100:1695–703.
Hershko-Klement A, Tepper R. Ultrasound in assisted reproduction: a call to fill the endometrial gap. Fertil Steril. 2016;105(6):1394–402.
McWilliams GD, Frattarelli JL. Changes in measured endometrial thickness predict in vitro fertilization success. Fertil Steril. 2007;88(1):74–81.
Zhao J, Zhang Q, Wang Y, Li Y. Endometrial pattern, thickness and growth in predicting pregnancy outcome following 3319 IVF cycles. Reprod BioMed Online. 2014;29(3):291–8.
Ghobara T, Gelbaya TA, Ayeleke RO. Cycle regimens for frozen-thawed embryo transfer. Cochrane Database Syst Rev. 2017;7:CD003414.
El-Toukhy T, Coomarasamy A, Khairy M, Sunkara K, Seed P, Khalaf Y, et al. The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles. Fertil Steril. 2008;89:832–9.
Check JH, Dietterich C, Graziano V, Lurie D, Choe JK. Effect of maximal endometrial thickness on outcome after frozen embryo transfer. Fertil Steril. 2004;81(5):1399–400.
Bu Z, Wang K, Dai W, Sun Y. Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles. Gynecol Endocrinol. 2016;32(7):524–8.
Ma NZ, Chen L, Dai W, Bu ZQ, Hu LL, Sun YP. Influence of endometrial thickness on treatment outcomes following in vitro fertilization/intracytoplasmic sperm injection. Reprod Biol Endocrinol. 2017;15:5.
Basir GS, WS O, So WW, Ng EH, Ho PC. Evaluation of cycle-to-cycle variation of endometrial responsiveness using transvaginal sonography in women undergoing assisted reproduction. Ultrasound Obstet Gynecol. 2002;19(5):484–9.
Shirlow R, Healey M, Volovsky M, MacLachlan V, Vollenhoven B. The effects of adjuvant therapies on embryo transfer success. J Reprod Infertil. 2017;18(4):368–78.
Kroon B, Hart RJ, Wong BM, Ford E, Yazdani A. Antibiotics prior to embryo transfer in ART. Cochrane Database Syst Rev. 2012;3:CD008995.
Kaye L, Bartels C, Bartolucci A, Engmann L, Nulsen J, Benadiva C. Old habits die hard: retrospective analysis of outcomes with use of corticosteroids and antibiotics before embryo transfer. Fertil Steril. 2017;107(6):1336–40.
Moore DE, Soules MR, Klein NA, Fujimoto VY, Agnew KJ, Eschenbach DA. Bacteria in the transfer catheter tip influence the live-birth rate after in vitro fertilization. Fertil Steril. 2000;74(6):1118–24.
Iatrakis G, Stoikidou M, Anthouli-Anagnostopoulou F, Vouxinou A, Tsionis C, Adonakis G, et al. Polycystic ovarian syndrome, insulin resistance and thickness of the endometrium. Eur J Obstet Gynecol Reprod Biol. 2006;127(2):218–21.
Flannery CA, Saleh FL, Choe GH, Selen DJ, Kodaman PH, Kliman HJ, et al. Differential expression of IR-A, IR-B and IGF-1R in endometrial physiology and distinct signature in adenocarcinoma. J Clin Endocrinol Metab. 2016;101(7):2883–91.
Glujovsky D, Farquhar C, Quinteiro Retamar AM, Alvarez Sedo CR, Blake D. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev. 2016;6:CD002118.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethics Approval
This study was approved by the Institutional Review Board of Northwestern University STU00206489.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Babayev, E., Matevossian, K., Hensley, C. et al. Baseline Endometrial Thickness or Endometrial Thickness Change in Response to Estrogen Is Not Predictive of Frozen Embryo Transfer Success in Medicated Cycles. Reprod. Sci. 27, 2242–2246 (2020). https://doi.org/10.1007/s43032-020-00233-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s43032-020-00233-3