Effect of endometrial thickness and embryo quality on live-birth rate of fresh IVF/ICSI cycles: a retrospective cohort s
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(2020) 18:89
RESEARCH
Open Access
Effect of endometrial thickness and embryo quality on live-birth rate of fresh IVF/ICSI cycles: a retrospective cohort study Hong Lv1,2†, Xiuzhu Li1†, Jiangbo Du1,2†, Xiufeng Ling3, Feiyang Diao4, Qun Lu1,2, Shiyao Tao1,2, Lei Huang1,2, Shiyao Chen1, Xiumei Han1, Kun Zhou1, Bo Xu1, Xiaoyu Liu1, Hongxia Ma1,2, Yankai Xia1, Hongbing Shen1,2, Zhibin Hu1,2, Guangfu Jin1,2* , Yichun Guan5* and Xinru Wang1*
Abstract Background: Successful implantation and delivery require both the functional embryo and receptive endometrium in assisted reproductive technology (ART) cycles. However, little is known about embryo-endometrial interaction on live-birth. We aimed to investigate the independent effect and interaction of endometrial thickness (EMT) and embryo quality on live-birth in fresh embryo transfer (ET) cycles. Methods: We conducted a retrospective cohort study including 15,012 ART cycles between 2013 and 2016 in three centers in China. Poisson regression with generalized estimating equations was employed to calculate relative risks (RRs) and 95% confidence intervals (CIs). We estimated the interaction of embryo quality and EMT on live-birth rate (LBR). Results: The LBR per cycle was 42.8% overall. LBR increased with increasing EMT and reached a plateau (50.6 to 54.2%) when EMT was 11 mm or thicker. Embryo quality represented by cumulative score was associated with LBR independently of number of embryos transferred and EMT. LBR was not increased with thicker EMT when only Q1 cleavage-stage embryo transferred (aRR 0.95, 95%CI 0.61–1.46). LBR was not increased significantly with thicker EMT with transfer of two good-quality cleavage-stage embryos and any blastocyst combination except Q1 group. There was significant interaction between EMT and embryo quality on LBR for cleavage-stage ETs (P=0.023). Conclusions: This study demonstrated the nonlinear EMT-LBR association and the EMT cut-off value of 11 mm which may be of more clinical significance for predicting live-birth. Embryo quality is an independent prognostic tool for LBR. Our finding of significant embryo-endometrial interaction indicates combination of EMT and embryos quality might improve the prognostic value in clinical practice for live-birth in patients undergoing transfer of 1–2 fresh cleavage-stage embryos. Keywords: Endometrial thickness, Embryo quality, IVF/ICSI, Live-birth rate per cycle, Interaction
* Correspondence: [email protected]; [email protected]; [email protected] † Hong Lv, Xiuzhu Li and Jiangbo Du contributed equally to this work. 1 State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing 211166, China 5 Department of Reproduction, Henan Medical Maternity and Child Health Care Hospital, Henan 450052, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medi
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