Jin Qingmei, Sun Zhengao, Guo Zizhen
The First Clinical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Department of Reproduction and Genetics, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China.
Front Endocrinol (Lausanne). 2025 May 19;16:1554201. doi: 10.3389/fendo.2025.1554201. eCollection 2025.
Endometrial compaction is known to positively influence pregnancy outcomes in patients with infertility undergoing assisted reproductive technology. However, the impact of endometrial compaction on pregnancy outcomes in patients with chronic endometritis following antibiotic treatment is not well understood.Considering the unique characteristics of patients with chronic endometritis, we aimed to investigate whether endometrial compaction predicts pregnancy outcomes during frozen-thawed embryo transfer cycles in this population.
We enrolled 769 patients who underwent hysteroscopy before frozen-thawed embryo transfer over the past 3 years and subsequently categorized them into the populations with and without chronic endometritis to analyze the impact of endometrial compaction on pregnancy outcomes. To adjust for potential confounding factors, a multifactor binary logistic regression analysis was conducted using clinical co-variables that may have impacted the cycle results.
In patients with chronic endometritis following antibiotic treatment, endometrial compaction was not significantly associated with biochemical pregnancy (adjusted odds ratio [AOR] = 1.020, 95% confidence interval [CI] = 0.639-1.627), clinical pregnancy (AOR = 1.028, 95% CI = 0.643-1.643), ectopic pregnancy (AOR = 2.003, 95% CI = 0.145-27.635), early pregnancy loss (AOR = 1.356, 95% CI = 0.502-3.663), ongoing pregnancy (AOR = 0.970, 95% CI = 0.600-1.569), and live birth (AOR = 0.881, 95% CI 0.545-1.423). However, endometrial compaction was related to higher rates of clinical pregnancy (AOR = 1.623, 95% CI = 1.052-2.504), ongoing pregnancy (AOR = 2.193, 95% CI = 1.403-3.429), and live birth (AOR = 2.244, 95% CI = 1.431-3.520) in patients without chronic endometritis.
Endometrial compaction was associated with improved pregnancy outcomes in patients without chronic endometritis but did not predict pregnancy outcomes in those with chronic endometritis, even after antibiotic treatment, suggesting that other factors influence pregnancy success in this population.
已知子宫内膜致密化对接受辅助生殖技术的不孕症患者的妊娠结局有积极影响。然而，抗生素治疗后慢性子宫内膜炎患者的子宫内膜致密化对妊娠结局的影响尚不清楚。考虑到慢性子宫内膜炎患者的独特特征，我们旨在研究子宫内膜致密化是否能预测该人群冻融胚胎移植周期的妊娠结局。
我们纳入了过去3年中在冻融胚胎移植前接受宫腔镜检查的769例患者，随后将他们分为有和没有慢性子宫内膜炎的人群，以分析子宫内膜致密化对妊娠结局的影响。为了调整潜在的混杂因素，我们使用可能影响周期结果的临床协变量进行了多因素二元逻辑回归分析。
在抗生素治疗后的慢性子宫内膜炎患者中，子宫内膜致密化与生化妊娠（调整优势比[AOR]=1.020，95%置信区间[CI]=0.639-1.627）、临床妊娠（AOR=1.028，95%CI=0.643-1.643）、异位妊娠（AOR=2.003，95%CI=0.145-27.635）、早期妊娠丢失（AOR=1.356，95%CI=0.502-3.663）、持续妊娠（AOR=0.970，95%CI=0.600-1.569）和活产（AOR=0.881，95%CI 0.545-1.423）均无显著相关性。然而，在没有慢性子宫内膜炎的患者中，子宫内膜致密化与较高的临床妊娠率（AOR=1.623，95%CI=1.052-2.504）、持续妊娠率（AOR=2.193，95%CI=1.403-3.429）和活产率（AOR=2.244，95%CI=1.431-3.520）相关。
子宫内膜致密化与没有慢性子宫内膜炎的患者改善的妊娠结局相关，但即使在抗生素治疗后，也不能预测慢性子宫内膜炎患者的妊娠结局，这表明其他因素影响该人群的妊娠成功率。
