Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, FL, USA.
Reproductive Endocrinology and Infertility Program, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA.
Reprod Biomed Online. 2023 Oct;47(4):103259. doi: 10.1016/j.rbmo.2023.103259. Epub 2023 Jul 3.
A receptive endometrium is required for successful embryo implantation. Endometrial thickness, as measured by ultrasonography, is the most commonly used marker of endometrial receptivity in assisted reproductive technology cycles. Several factors simultaneously affect both endometrial thickness and probability of live birth, including age, oestradiol concentration and oocyte number, among others. Most of the studies investigating a relationship between endometrial thickness and embryo transfer outcomes are retrospective and do not adequately address confounding factors, in addition to other limitations. Despite multiple meta-analyses and studies with large numbers of cycles, controversy still exists. The difference between the results from prospective and retrospective studies is also striking. This article presents a critical appraisal of the studies on endometrial thickness and embryo transfer outcomes in order to highlight methodological issues and how they can be overcome in future studies. Currently available evidence does not seem to support a modification of management just because endometrial thickness is below an arbitrary threshold.
接受性子宫内膜是胚胎着床成功的必要条件。子宫内膜厚度是辅助生殖技术周期中最常用的子宫内膜容受性标志物，通过超声测量。有几个因素同时影响子宫内膜厚度和活产概率，包括年龄、雌二醇浓度和卵子数量等。大多数研究子宫内膜厚度与胚胎移植结局之间的关系的研究都是回顾性的，除了其他限制外，还不能充分解决混杂因素。尽管进行了多次荟萃分析和大量周期研究，但仍存在争议。前瞻性研究和回顾性研究的结果之间的差异也很明显。本文对子宫内膜厚度与胚胎移植结局的研究进行了批判性评价，以突出方法学问题以及如何在未来的研究中克服这些问题。目前的证据似乎并不支持仅仅因为子宫内膜厚度低于任意阈值就改变管理。
