自然周期 IVF 中胚胎质量和子宫内膜厚度对着床的影响。
Impact of embryo quality and endometrial thickness on implantation in natural cycle IVF.
机构信息
Department of Obstetrics and Gynecology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020, Salzburg, Austria.
Department of Obstetrics and Gynecology, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, Zagreb, Croatia.
出版信息
Arch Gynecol Obstet. 2020 May;301(5):1325-1330. doi: 10.1007/s00404-020-05507-4. Epub 2020 Mar 24.
PURPOSE
The aim of this study is to assess the effect of the endometrial thickness and embryo quality on the implantation potential in natural cycle IVF (NC-IVF).
METHODS
A retrospective single-center study was performed on 552 single embryo transfers after NC-IVF. The 'quality' of the embryos was evaluated trough the number and regularity of blastomeres, degree of fragmentation, and nuclear content of cells. Endometrial thickness was measured in millimeters with transvaginal ultrasound on the day of hCG application.
RESULTS
Our findings showed a statistically significant difference in successful implantation until a plateau of 10 mm is reached (p = 0.001). Only one pregnancy was achieved where endometrial thickness was less than 7 mm, and this resulted in an early miscarriage. The predictors of favorable implantation were fragmentation (≤ 10%, p < 0.05) and the number of blastomeres (preferably 8-cell, p < 0.01) on day 3. Embryo quality (R = 0.052) and endometrial thickness (R = 0.18) were closely related to pregnancy rate. The overall implantation rate per embryo transfer was 18.8%.
CONCLUSIONS
Embryo quality and endometrial thickness have a significant impact on implantation in NC-IVF. Highest implantation potential has an 8-cell embryo with ≤ 10% fragmentation in the third day following oocyte retrieval. Endometrial thickness of at least 7 mm seems to be the optimal edge of successful pregnancy.
目的
本研究旨在评估子宫内膜厚度和胚胎质量对自然周期 IVF（NC-IVF）中着床潜能的影响。
方法
对 552 例 NC-IVF 后单胚胎移植进行回顾性单中心研究。通过卵裂球的数量和规则性、碎片程度和细胞核内容来评估胚胎的“质量”。在 hCG 应用日，通过经阴道超声以毫米为单位测量子宫内膜厚度。
结果
我们的研究结果表明，在达到 10mm 的平台之前，成功着床存在统计学显著差异（p=0.001）。只有在子宫内膜厚度小于 7mm 的情况下才发生一次妊娠，并导致早期流产。有利于着床的预测因子是碎片（≤10%，p<0.05）和第 3 天的卵裂球数量（最好为 8 细胞，p<0.01）。胚胎质量（R=0.052）和子宫内膜厚度（R=0.18）与妊娠率密切相关。胚胎移植的总着床率为 18.8%。
结论
胚胎质量和子宫内膜厚度对 NC-IVF 中的着床有显著影响。在取卵后第 3 天，具有≤10%碎片的 8 细胞胚胎具有最高的着床潜能。子宫内膜厚度至少为 7mm 似乎是成功妊娠的最佳边缘。
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