Ma Ning-Zhao, Chen Lei, Dai Wei, Bu Zhi-Qin, Hu Lin-Li, Sun Ying-Pu
Department of Reproductive Medical Center, First Affiliated Hospital of Zhengzhou University, JianShe Dong Road, Erqi District, Zhengzhou, Henan Province, People's Republic of China.
Reprod Biol Endocrinol. 2017 Jan 5;15(1):5. doi: 10.1186/s12958-016-0222-5.
The study was designed to investigate the roles of endometrial thickness (EMT) at the day of human chorionic gonadotropin (hCG) administration on pregnancy outcomes in a large patient population.
This retrospective cohort study included 9,952 patients undergoing their first IVF/ICSI with autologous oocytes from January 2011 to January 2015. Patients were divided into three groups based on the EMT (group A:≤8 mm; group B: 9-14 mm and group C:≥15 mm). Live birth rate (LBR), clinical pregnancy rate (CPR), early miscarriage rate (EMR), and ectopic pregnancy rate (EPR) were analyzed. Additionally, the live birth rate was analyzed for patients with single or double gestational sacs.
Significant differences (p < 0.05) were detected in the LBRs (30.38%, 45.73% and 54.55% for groups A, B, and C, respectively), CPRs (38.57%, 55.04% and 64.32%, respectively), and EPRs (5.58%, 3.48% and 2.19%, respectively), with thicker endometrial thickness favoring all three parameters. However, no differences were found in the EMRs among the three groups (15.64%, 13.44% and 13.05%, respectively, p > 0.05). After adjusting for female age, body mass index (BMI) and endometrial pattern, the multivariate logistic regression analysis demonstrated that the associations between EMT and LBR (adjusted OR: 2.645; 95% CI 2.020-3.464; p < 0.01), CPR (adjusted OR 2.693 95% CI 2.012-3.605 p < 0.01), and EPR (adjusted OR: 0.298 95% CI 0.101-0.713; p < 0.05) were significant. Additionally, live birth rates in the double gestational sac group were different (p < 0.05) among patients with different EMT (72.73%, 87.28%, and 87.36%, respectively), whereas no difference was found in the single gestational sac group. In the double gestational sac group, LBR was positively correlated with increasing endometrial thickness only in patients with twin pregnancies but not in patients with singletons.
Our study shows that endometrial thickness at the day of hCG administration has an effect on LBR, CPR and EPR, with all three parameters increasing with the EMT. Furthermore, successful twin pregnancies are associated with a thicker endometrium.
本研究旨在调查在大量患者群体中，人绒毛膜促性腺激素（hCG）注射日的子宫内膜厚度（EMT）对妊娠结局的影响。
这项回顾性队列研究纳入了2011年1月至2015年1月期间9952例接受首次自体卵母细胞体外受精/卵胞浆内单精子注射（IVF/ICSI）的患者。根据EMT将患者分为三组（A组：≤8mm；B组：9 - 14mm；C组：≥15mm）。分析活产率（LBR）、临床妊娠率（CPR）、早期流产率（EMR）和异位妊娠率（EPR）。此外，还分析了单胎或双胎妊娠囊患者的活产率。
在LBR（A组、B组和C组分别为30.38%、45.73%和54.55%）、CPR（分别为38.57%、55.04%和64.32%）和EPR（分别为5.58%、3.48%和2.19%）方面检测到显著差异（p < 0.05），子宫内膜越厚，这三个参数越有利。然而，三组之间的EMR没有差异（分别为15.64%、13.44%和13.05%，p > 0.05）。在调整了女性年龄、体重指数（BMI）和子宫内膜形态后，多因素逻辑回归分析表明，EMT与LBR（调整后的OR：2.645；95%CI 2.020 - 3.464；p < 0.01）、CPR（调整后的OR 2.693 95%CI 2.012 - 3.605 p < 0.01）和EPR（调整后的OR：0.298 95%CI 0.101 - 0.713；p < 0.05）之间的关联具有显著性。此外，不同EMT的双胎妊娠囊组患者的活产率不同（p < 0.05）（分别为72.73%、87.28%和87.36%），而单胎妊娠囊组未发现差异。在双胎妊娠囊组中，仅双胎妊娠患者的LBR与子宫内膜厚度增加呈正相关，而单胎妊娠患者则不然。
我们的研究表明，hCG注射日的子宫内膜厚度对LBR、CPR和EPR有影响，这三个参数均随EMT增加。此外，成功的双胎妊娠与较厚的子宫内膜有关。
