Infertility and IVF UnitHelen Schneider Hospital for WomenRabin Medical CenterBeilinson HospitalPetach Tikva4941492Israel; Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael.
Infertility and IVF UnitHelen Schneider Hospital for WomenRabin Medical CenterBeilinson HospitalPetach Tikva4941492Israel; Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael.
Reprod Biomed Online. 2018 Sep;37(3):341-348. doi: 10.1016/j.rbmo.2018.05.013. Epub 2018 Aug 23.
Does endometrial thickness affect the occurrence of obstetric complications in fresh IVF cycles?
We conducted a retrospective cohort study that included all singleton deliveries resulting from fresh embryo transfers in a single centre between 2008 and 2014. Obstetric complications, i.e. preeclampsia, placental abruption, placenta previa, small for gestational age and preterm delivery, in singleton live births were compared among patients with an endometrial thickness of less than 7.5 mm and 7.5 mm or over on day of HCG triggering. We adjusted for confounders, including maternal age, body mass index, smoking, peak oestradiol, parity, chronic hypertension, pre-gestational diabetes, gestational diabetes, vanishing twin, inherited or acquired thrombophilia, and past pregnancy complications.
A total of 5546 fresh embryo transfer cycles were carried out during the study period, of which 864 singleton deliveries met inclusion criteria. After adjusting for potential confounders, an endometrial thickness of less than 7.5 mm was found to be associated with increased risk for adverse obstetric outcome (adjusted OR 1.53; 95% CI 1.03 to 2.42; P = 0.04) even after excluding patients with prior pregnancy complications (adjusted OR 2.2; 95% CI 1.05 to 4.59; P = 0.035).
Our results demonstrated that a thin endometrial lining was associated with obstetric complications that might be related to poor placentation. These findings should be validated in large prospective cohort studies.
子宫内膜厚度是否会影响新鲜试管婴儿周期中产科并发症的发生？
我们进行了一项回顾性队列研究，纳入了 2008 年至 2014 年期间在单一中心进行的所有新鲜胚胎移植的单胎分娩。比较了在 hCG 触发日子宫内膜厚度＜7.5mm 和≥7.5mm 的患者中，子痫前期、胎盘早剥、前置胎盘、胎儿生长受限和早产等产科并发症的发生率。我们调整了混杂因素，包括母亲年龄、体重指数、吸烟、雌二醇峰值、产次、慢性高血压、孕前糖尿病、妊娠期糖尿病、双胎消失、遗传性或获得性血栓形成倾向以及既往妊娠并发症。
在研究期间共进行了 5546 个新鲜胚胎移植周期，其中 864 个单胎分娩符合纳入标准。调整潜在混杂因素后，发现子宫内膜厚度＜7.5mm 与不良产科结局风险增加相关（调整 OR 1.53；95%CI 1.03 至 2.42；P=0.04），甚至在排除既往妊娠并发症的患者后（调整 OR 2.2；95%CI 1.05 至 4.59；P=0.035）也是如此。
我们的结果表明，薄的子宫内膜与可能与不良胎盘形成有关的产科并发症有关。这些发现应在大型前瞻性队列研究中得到验证。
