Endometrial thickness affects the outcome of in vitro fertilization and embryo transfer in normal responders after GnRH
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RESEARCH
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Endometrial thickness affects the outcome of in vitro fertilization and embryo transfer in normal responders after GnRH antagonist administration Yu Wu1, Xiaohong Gao1, Xiang Lu2, Ji Xi2, Shan Jiang2, Yin Sun2 and Xiaowei Xi1*
Abstract Background: The goal of this study was to assess the association between endometrial thickness on the chorionic gonadotropin (hCG) day and in vitro fertilization and embryo transfer (IVF-ET) outcome in normal responders after GnRH antagonist administration. Methods: A retrospective cohort study was performed in normal responders with GnRH antagonist administration from January 2011–December 2013. Patients were divided into four groups according to endometrial thickness, as follows: = 7- < 8 mm (group 2), > = 8- < 14 mm (group 3), and > =14 mm (group 4). Results: A total of 2106 embryo transfer cycles were analyzed. The pregnancy rate (PR) was 44.87%.The clinical pregnancy rate, ongoing pregnancy rate and the implantation rate (17.28%, 13.79%, 10.17%, respectively) were significantly lower in group 1 compared to the other three groups (p < 0.05). The miscarriage rate was higher in patients with endometrial thickness less than 7 mm. The clinical pregnancy rate, ongoing pregnancy rate and implantation rate were highest in patients with endometrial thickness higher than 14 mm, but showed no difference in patients with those of endometrial thickness between 8-14 mm. Conclusions: There is a correlation between endometrial thickness measured on hCG day and clinical outcome in normal responders with GnRH antagonist administration. The pregnancy rate was lower in patients with endometrial thickness less than 7 mm compared with patients with endometrial thickness more than 7 mm. Keywords: Endometrial thickness, IVF-ET, GnRH antagonist, Pregnancy rate
Background In-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) are widely accepted as effective treatment for most causes of infertility. Gonadotropin-releasing hormone (GnRH) antagonist is now widely used in controlled ovarian stimulation cycles, which requires less follicle stimulation, and has lower risk for ovarian hyperstimulation syndrome (OHSS) [1,2]. A randomized controlled trial (RCT) showed that normal responders treated with the GnRH antagonist protocol exhibited the same high * Correspondence: [email protected] 1 Reproductive Medicine, Department of Obstetrics and Gynecology, Shanghai Jiaotong University Affiliated First People’s Hospital, No. 650, New Songjiang Road, Shanghai 201620, China Full list of author information is available at the end of the article
success rates as patients treated with the long GnRH agonist protocol. The GnRH antagonist protocol is as effective and safe as the long GnRH agonist protocol [3]. Age, quality of the embryo and endometrial receptivity are the most important factors for the success of IVF. Endometrial thickness (EMT) has been accepted as an indicator for endometrial receptivity, and assessment of the endometrium in the midsagittal plane via trans
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