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Endometrial compaction is associated with increased clinical and ongoing pregnancy rates in unstimulated natural cycle frozen embryo transfers: a prospective cohort study

  • Assisted Reproduction Technologies
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Abstract

Purpose

To investigate the association between endometrial compaction and pregnancy rates in unstimulated natural cycle frozen embryo transfers.

Design

A single-center prospective cohort study. Endometrial thickness by transvaginal ultrasound and blood progesterone levels on the day of ovulation and the day of embryo transfer were evaluated in patients undergoing natural cycle frozen embryo transfer. Compaction was defined as > 5% decrease in endometrial thickness between ovulation day and day of transfer. Clinical and ongoing pregnancy rates in cycles with and without compaction were compared.

Results

Seventy-one women were included, of which 44% had endometrial compaction, with similar rates when subdividing the patients by day of transfer (day 3 or day 5). Clinical and ongoing pregnancy rates were higher in the compaction group compared to the non-compaction group (0.58 vs. 0.16, P < 0.001; 0.52 vs. 0.13, P < 0.001 respectively). Subdividing by degree of compaction > 10% and > 15% revealed similar pregnancy rates as > 5%, with no added benefit to higher degrees of compaction.

Conclusions

About half the patients in our study undergoing unstimulated natural cycle frozen embryo transfer experienced compaction of the endometrium, occurring as early as day 3 post-ovulation. This was significantly correlated with increased clinical and ongoing pregnancy rates.

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Author information

Authors and Affiliations

  1. Department of Obstetrics & Gynecology, IVF Unit, Shamir Medical Center, 70300, Zerifin, Israel

    Michal Youngster, Matan Mor, Alon Kedem, Itai Gat, Gil Yerushalmi, Yariv Gidoni, Jonathan Barkat, Ohad Baruchin, Ariel Revel, Ariel Hourvitz & Sarit Avraham

  2. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Michal Youngster, Matan Mor, Alon Kedem, Itai Gat, Gil Yerushalmi, Yariv Gidoni, Jonathan Barkat, Ohad Baruchin, Ariel Revel, Ariel Hourvitz & Sarit Avraham

  3. Sperm Bank & Andrology Unit, Shamir Medical Center, Zerifin, Israel

    Itai Gat

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  1. Michal Youngster
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Contributions

A. H., M. Y., and S. A. designed the study. All authors contributed to data collection, M. Y., A. H., and S.A. drafted the first version of the manuscript. M. Y., A. H., and S. A. contributed to data analysis and interpretation. All authors revised the manuscript and approved the final submitted version.

Corresponding author

Correspondence to Michal Youngster.

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Youngster, M., Mor, M., Kedem, A. 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 39, 1909–1916 (2022). https://doi.org/10.1007/s10815-022-02544-7

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  • DOI: https://doi.org/10.1007/s10815-022-02544-7

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