Hou Zhaojuan, Xu Bin, Zhao Jing, Zhang Qiong, Yang Tianli, Tian Fen, Wang Baisheng, Li Yanping
Department of Reproductive Medicine, Xiangya Hospital, Central South University, Changsha City, Hunan Province, People's Republic of China.
Clinical Research Center for Women's Reproductive Health in Hunan Province, Changsha City, Hunan Province, People's Republic of China.
Int J Womens Health. 2025 May 13;17:1363-1374. doi: 10.2147/IJWH.S521115. eCollection 2025.
This study aimed to investigate whether endometrial thickness (EmT) change prognosticates the ongoing pregnancy rate (OPR) in hormonally prepared frozen-thawed embryo transfers (FETs) in women with treated intrauterine adhesion (IUA).
We prospectively examined 261 FET cycles in women with IUA. Ultimately, 156 patients were included in the final analysis. The primary outcome was OPR. The association between the EmT change ratio and OPR, as well as the relationship between the EmT change and serum hormone concentration, was analyzed.
The intraclass correlation coefficient for repeated EmT measurements was 0.944 (95% CI: 0.933-0.954, P < 0.001). Subdividing by the expansion cutoff from 5% to 15%, the 10% expansion group had the highest OPR with optimal sensitivity and specificity. Regarding the baseline characteristics, there were no statistically significant differences between the two groups. Nevertheless, the OPR increased significantly in cycles with endometrial expansion ≥ 10% compared to those with no expansion (55.3% vs 26.3%, P=0.001). The difference was still significant after adjustment between the two groups (adjusted OR, 3.74; 95% CI 1.68-8.34, P=0.001). No correlation was found between the EmT change and serum hormone concentrations.
Endometrial expansion was significantly correlated with higher OPR in women with treated IUA in the hormonal protocol for FET.
本研究旨在调查在接受治疗的宫腔粘连（IUA）女性中，激素预处理的冻融胚胎移植（FET）过程中子宫内膜厚度（EmT）的变化是否可预测持续妊娠率（OPR）。
我们前瞻性地检查了261例IUA女性的FET周期。最终，156例患者纳入最终分析。主要结局为OPR。分析了EmT变化率与OPR之间的关联，以及EmT变化与血清激素浓度之间的关系。
重复EmT测量的组内相关系数为0.944（95%CI：0.933 - 0.954，P < 0.001）。以5%至15%的扩张临界值进行细分，10%扩张组的OPR最高，敏感性和特异性最佳。关于基线特征，两组之间无统计学显著差异。然而，与无扩张的周期相比，子宫内膜扩张≥10%的周期OPR显著增加（55.3%对26.3%，P = 0.001）。两组调整后差异仍显著（调整后OR，3.74；95%CI 1.68 - 8.34，P = 0.001）。未发现EmT变化与血清激素浓度之间存在相关性。
在接受治疗的IUA女性的FET激素方案中，子宫内膜扩张与较高的OPR显著相关。
