Correlation between endometrial thickness and perinatal outcome for pregnancies achieved through assisted reproduction technology

Liren He; Zheng Zhang; Hongmei Li; Yuyan Li; Ling Long; Wei He

doi:10.1515/jpm-2019-0159

Article

Correlation between endometrial thickness and perinatal outcome for pregnancies achieved through assisted reproduction technology

Liren He , Zheng Zhang , Hongmei Li , Yuyan Li , Ling Long and Wei He

Published/Copyright: December 12, 2019

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From the journal Journal of Perinatal Medicine Volume 48 Issue 1

Abstract

Objective

To explore the relationship between endometrial thickness and perinatal outcome in assisted reproductive techniques (ART).

Methods

A retrospective cohort study was conducted in 1139 infertile women who underwent ART treatment from January 2011 to July 2014. Four groups were divided by endometrial thickness on the human chorionic gonadotropin (HCG) trigger day in fresh embryo transfer cycles or on the progesterone administration day in frozen embryo transfer cycles, as group A (<8 mm), group B (8–10 mm), group C (10–14 mm) and group D (≥14 mm). Two other groups were delineated according to whether uterine lesions were present. The incidence of premature rupture of membranes (PROM), postpartum hemorrhage (PPH) and other common perinatal complications were observed subsequently.

Results

It was found that the highest incidence of PROM and PPH was in group A (P < 0.05). The incidence of PROM in group B was higher than in groups C and D (P < 0.05). The occurrence of mothers entering the intensive care unit (ICU) was significantly higher in group A than in group B (P < 0.05). However, no significant differences were found in other adverse outcomes. There was no difference in the incidence of adverse perinatal outcome when the endometrial thickness of pre-implantation was not attenuated by uterine lesions.

Conclusion

The incidence of PROM and PPH increased significantly when the thickness of the endometrium was less than 10 mm before implantation. Correspondingly, the number of mothers treated in the ICU was also higher under these circumstances. To reduce such perinatal placenta-related complications, we should maximize the thickness of the endometrium before transplantation of embryos.

Keywords: assisted reproductive technology; endometrial thickness; perinatal outcome

Acknowledgments

We sincerely thank the women who participated in the study. The authors would like to thank Dr. Dev Sooranna, Imperial College London, for editing the manuscript.

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This work was supported by grants from the study on the safety of female reproduction and assisted reproductive technology and the 2015 Merck Reproductive Medicine Research Foundation of China (CREATE Foundation: WX20115-015).
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Chambers GM, Lee E, Hoang VP, Hansen M, Bower C, SullivanEA. Hospital utilization, costs and mortality rates during the first 5 years of life: a population study of ART and non-ART singletons. Hum Reprod 2014;29:601–10.10.1093/humrep/det397Search in Google Scholar PubMed

2. Palomba S, Homburg R, Santagni S, La Sala GB, Orvieto R. Risk of adverse pregnancy and perinatal outcomes after high technology infertility treatment: a comprehensive systematic review. Reprod Biol Endocrinol 2016;14:76.10.1186/s12958-016-0211-8Search in Google Scholar PubMed PubMed Central

3. Ombelet W, Martens G, Bruckers L. Pregnant after assisted reproduction: a risk pregnancy is born! 18-years perinatal outcome results from a population-based registry in Flanders, Belgium. Facts Views Vis Obgyn 2017;8:193–204.Search in Google Scholar

4. Maheshwari A, Pandey S, Shetty A, Hamilton M, Bhattacharya S. Obstetric and perinatal outcomes in singleton pregnancies resulting from the transfer of frozen thawed versus fresh embryo generated through in vitro fertilization treatment: a systematic review and meta-analysis. Fertil Steril 2012;98:368–77.10.1016/j.fertnstert.2012.05.019Search in Google Scholar PubMed

5. Kalra SK, Ratcliffe SJ, Coutifaris C, Molinaro T, Barnhart KT. Ovarian stimulation and low birth weight in newborns conceived in vitro fertilization. Obstet Gynecol 2011;118:863–71.10.1097/AOG.0b013e31822be65fSearch in Google Scholar PubMed PubMed Central

6. Raatikainen K, Kulvasaari-Pirinen P, Hippelainen M, Helmonen S. Comparison of the pregnancy outcomes of subfertile women after infertility treatment and in naturally conceived pregnancies. Hum Reprod 2012;27:1162–9.10.1093/humrep/des015Search in Google Scholar PubMed

7. Bu Z, Sun Y. The impact of endometrial thickness on the day of human chorionic gonadotrophin (hCG) administration on ongoing pregnancy rate in patients with different ovarian response. PLoS One 2015;10:e0145703.10.1371/journal.pone.0145703Search in Google Scholar PubMed PubMed Central

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;15:5.10.1186/s12958-016-0222-5Search in Google Scholar PubMed PubMed Central

9. Chan JM, Sukumar AI, Ramalingam M, Ranbir Singh SS, Abdullah MF. The impact of endometrial thickness (EMT) on the day of human chorionic gonadotropin (hCG) administration on pregnancy outcomes: a 5-year retrospective cohort analysis in Malaysia. Fertil Res Pract 2018;4:5.10.1186/s40738-018-0050-8Search in Google Scholar PubMed PubMed Central

10. Oron G, Hiersch L, Rona S, Prag-Rosenberg R, Sapir O, Tuttnauer-Hamburger M, et al. Endometrial thickness of less than 7.5 mm is associated with obstetric complications in fresh IVF cycles: a retrospective cohort study. Reprod Biomed Online 2018;37:341–8.10.1016/j.rbmo.2018.05.013Search in Google Scholar PubMed

11. Alfer J, Happel L, Dittrich R, Beckmann MW, Hartmann A, Gaumann A, et al. Insufficient angiogenesis: cause of abnormally thin endometrium in subfertile patients? Geburtshilfe Frauenheilkd 2017;77:756–64.10.1055/s-0043-111899Search in Google Scholar PubMed PubMed Central

12. Di Renzo GC. The great obstetrical syndromes. J Matern Fetal Neonatal Med 2009;23:633–5.10.1080/14767050902866804Search in Google Scholar

13. Brosens I, Pijnenborg R, Vercruysse L, Romero R. The “Great Obstetrical Syndromes” are associated with disorders of deep placentation. Am J Obstet Gynecol 2011;204:193–201.10.1016/j.ajog.2010.08.009Search in Google Scholar

14. Meekins JW, Pijnenborg R, Hanssens M, McFadyen IR, van Asshe A. A study of placental bed spiral arteries and trophoblast invasion in normal and severe pre-eclamptic pregnancies. Br J Obstet Gynaecol 1994;101:669–74.10.1111/j.1471-0528.1994.tb13182.xSearch in Google Scholar

15. Odegård RA, Vatten LJ, Nilsen ST, Salvesen KA, Austgulen R. Preeclampsia and fetal growth. Obstet Gynecol 2000;96: 950–5.10.1097/00006250-200012000-00016Search in Google Scholar

16. Kim YM, Bujold E, Chaiworapongsa T, Gomez R, Yoon BH, ThalerHT, et al. Failure of physiologic transformation of the spiral arteries in patients with preterm labor and intact membranes. Am J Obstet Gynecol 2003;189:1063–9.10.1067/S0002-9378(03)00838-XSearch in Google Scholar

Received: 2019-05-04

Accepted: 2019-10-17

Published Online: 2019-12-12

Published in Print: 2019-12-18

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Articles in the same Issue

https://doi.org/10.1515/jpm-2019-0159

Keywords for this article

assisted reproductive technology; endometrial thickness; perinatal outcome