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子宫内膜厚度对活产率的影响:959 例未经厚度截点选择的单倍体冷冻胚胎移植的启示。

Effect of the endometrial thickness on the live birth rate: insights from 959 single euploid frozen embryo transfers without a cutoff for thickness.

机构信息

ART Fertility Clinics, Dubai, United Arab Emirates; Department of Obstetrics and Gynecology, Koç University School of Medicine, Istanbul, Turkish Republic.

ART Fertility Clinics, Muscat, Oman.

出版信息

Fertil Steril. 2023 Jul;120(1):91-98. doi: 10.1016/j.fertnstert.2023.02.035. Epub 2023 Mar 2.

Abstract

OBJECTIVE

To investigate whether endometrial thickness (ET) independently affects the live birth rate (LBR) after embryo transfer.

DESIGN

Retrospective study.

SETTING

Private assisted reproductive technology center.

PATIENT(S): A total of 959 single euploid frozen embryo transfers.

INTERVENTION(S): Vitrified euploid blastocyst transfer.

MAIN OUTCOME MEASURE(S): Live birth rate per embryo transfer.

RESULT(S): The conditional density plots did not demonstrate either a linear relationship between the ET and LBR or a threshold below which the LBR decreased perceivably. Receiver operating characteristic curve analyses did not suggest a predictive value of the ET for the LBR. The area under the curve values were 0.55, 0.54, and 0.54 in the overall, programmed, and natural cycle transfers, respectively. Logistic regression analyses with age, embryo quality, day of trophectoderm biopsy, body mass index, and ET did not suggest an independent effect of the ET on the LBR.

CONCLUSION(S): We did not identify a threshold of the ET that either precluded live birth or under which the LBR decreases perceivably. Common practice of cancelling embryo transfers when the ET is <7 mm may not be justified. Prospective studies, in which the management of the transfer cycle would not be altered by ET, would provide higher-quality evidence on the subject.

摘要

目的

研究子宫内膜厚度(ET)是否独立影响胚胎移植后的活产率(LBR)。

设计

回顾性研究。

地点

私立辅助生殖技术中心。

患者

共 959 例单倍体冷冻胚胎移植。

干预

玻璃化的整倍体囊胚移植。

主要观察指标

每次胚胎移植的活产率。

结果

条件密度图既没有显示 ET 与 LBR 之间存在线性关系,也没有显示出 LBR 明显下降的阈值。受试者工作特征曲线分析也没有提示 ET 对 LBR 有预测价值。曲线下面积在总体、程序化和自然周期转移中分别为 0.55、0.54 和 0.54。年龄、胚胎质量、滋养外胚层活检日、体重指数和 ET 的 logistic 回归分析均表明 ET 对 LBR 无独立影响。

结论

我们没有发现 ET 的阈值,要么排除活产,要么在这个阈值以下,LBR 明显下降。当 ET <7 mm 时取消胚胎移植的常见做法可能没有道理。如果不改变 ET 管理,前瞻性研究将为这一主题提供更高质量的证据。

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