Run Zhao, Qianyan Song, Xiaofang Li
Department of Reproductive Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China.
Department of Reproductive Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
BMJ Open. 2025 Apr 2;15(4):e094770. doi: 10.1136/bmjopen-2024-094770.
This study aimed to investigate the relationship between endometrial echo and pregnancy outcome in patients undergoing thawed embryo transfer and explore the effect of different endometrial preparation schemes on endometrial echo.
A retrospective analysis was conducted on data from 2910 patients who underwent freeze-thaw embryo transfer (FET)-assisted pregnancy in the reproductive medicine centre of our hospital from January 2019 to March 2024. Based on the endometrial echo on the transplantation day, the patients were divided into two groups: the endometrial echo uniform group and the endometrial echo uneven group. Based on the endometrial preparation protocol, they were divided into the natural cycle (NC) group, hormone replacement cycle (HRT) group, and downregulated combined HRT (GnRHa+HRT) group. The general data, pregnancy outcome and endometrial echo of those undergoing different endometrial preparation protocols were compared.
The clinical pregnancy rate in the homogeneous endometrial echo group was significantly higher than that in the non-homogeneous endometrial echo group. The equalisation rate of endometrial echo in the NC group and GnRHa+HRT group was significantly higher than that in the HRT group (p<0.05). Binary logistic regression analysis revealed that homogeneous endometrial echo was associated with a significantly improved clinical pregnancy rate of patients with FET. After adjusting for confounding factors, we found that compared with the HRT endometrial preparation protocol, NC and GnRHa+HRT endometrial preparation protocol significantly improved homogeneous endometrial echo.
Non-homogeneous endometrial echo on the transplantation day was associated with a decreased clinical pregnancy rate of FET. The endometrial preparation protocol of the NC and GnRHa+HRT cycle can improve homogeneous endometrial echo. In FET, clinicians should develop a personalised endometrial preparation protocol based on patients' situations.
本研究旨在探讨解冻胚胎移植患者子宫内膜回声与妊娠结局之间的关系，并探讨不同子宫内膜准备方案对子宫内膜回声的影响。
对2019年1月至2024年3月在我院生殖医学中心接受冻融胚胎移植（FET）辅助妊娠的2910例患者的数据进行回顾性分析。根据移植日的子宫内膜回声，将患者分为两组：子宫内膜回声均匀组和子宫内膜回声不均匀组。根据子宫内膜准备方案，将其分为自然周期（NC）组、激素替代周期（HRT）组和下调联合HRT（GnRHa+HRT）组。比较不同子宫内膜准备方案患者的一般资料、妊娠结局和子宫内膜回声。
子宫内膜回声均匀组的临床妊娠率显著高于子宫内膜回声不均匀组。NC组和GnRHa+HRT组的子宫内膜回声均匀率显著高于HRT组（p<0.05）。二元逻辑回归分析显示，子宫内膜回声均匀与FET患者临床妊娠率显著提高相关。在调整混杂因素后，我们发现与HRT子宫内膜准备方案相比，NC和GnRHa+HRT子宫内膜准备方案显著改善了子宫内膜回声均匀性。
移植日子宫内膜回声不均匀与FET临床妊娠率降低有关。NC和GnRHa+HRT周期的子宫内膜准备方案可改善子宫内膜回声均匀性。在FET中，临床医生应根据患者情况制定个性化的子宫内膜准备方案。
