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Reproductive Biology and Endocrinology
Published in: Reproductive Biology and Endocrinology 1/2020

01-12-2020 | Infertility | Research

Effect of endometrial thickness and embryo quality on live-birth rate of fresh IVF/ICSI cycles: a retrospective cohort study

Authors: Hong Lv, Xiuzhu Li, Jiangbo Du, Xiufeng Ling, Feiyang Diao, Qun Lu, Shiyao Tao, Lei Huang, Shiyao Chen, Xiumei Han, Kun Zhou, Bo Xu, Xiaoyu Liu, Hongxia Ma, Yankai Xia, Hongbing Shen, Zhibin Hu, Guangfu Jin, Yichun Guan, Xinru Wang

Published in: Reproductive Biology and Endocrinology | Issue 1/2020

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Abstract

Background

Successful implantation and delivery require both the functional embryo and receptive endometrium in assisted reproductive technology (ART) cycles. However, little is known about embryo-endometrial interaction on live-birth. We aimed to investigate the independent effect and interaction of endometrial thickness (EMT) and embryo quality on live-birth in fresh embryo transfer (ET) cycles.

Methods

We conducted a retrospective cohort study including 15,012 ART cycles between 2013 and 2016 in three centers in China. Poisson regression with generalized estimating equations was employed to calculate relative risks (RRs) and 95% confidence intervals (CIs). We estimated the interaction of embryo quality and EMT on live-birth rate (LBR).

Results

The LBR per cycle was 42.8% overall. LBR increased with increasing EMT and reached a plateau (50.6 to 54.2%) when EMT was 11 mm or thicker. Embryo quality represented by cumulative score was associated with LBR independently of number of embryos transferred and EMT. LBR was not increased with thicker EMT when only Q1 cleavage-stage embryo transferred (aRR 0.95, 95%CI 0.61–1.46). LBR was not increased significantly with thicker EMT with transfer of two good-quality cleavage-stage embryos and any blastocyst combination except Q1 group. There was significant interaction between EMT and embryo quality on LBR for cleavage-stage ETs (P=0.023).

Conclusions

This study demonstrated the nonlinear EMT-LBR association and the EMT cut-off value of 11 mm which may be of more clinical significance for predicting live-birth. Embryo quality is an independent prognostic tool for LBR. Our finding of significant embryo-endometrial interaction indicates combination of EMT and embryos quality might improve the prognostic value in clinical practice for live-birth in patients undergoing transfer of 1–2 fresh cleavage-stage embryos.
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Metadata
Title
Effect of endometrial thickness and embryo quality on live-birth rate of fresh IVF/ICSI cycles: a retrospective cohort study
Authors
Hong Lv
Xiuzhu Li
Jiangbo Du
Xiufeng Ling
Feiyang Diao
Qun Lu
Shiyao Tao
Lei Huang
Shiyao Chen
Xiumei Han
Kun Zhou
Bo Xu
Xiaoyu Liu
Hongxia Ma
Yankai Xia
Hongbing Shen
Zhibin Hu
Guangfu Jin
Yichun Guan
Xinru Wang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
Reproductive Biology and Endocrinology / Issue 1/2020
Electronic ISSN: 1477-7827
DOI
https://doi.org/10.1186/s12958-020-00636-6

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