scholarly journals Endometrial thickness is a limiting factor in achieving a successful pregnancy in infertile women undergoing IVF/ICSI cycle.

2021 ◽  
Author(s):  
Haroon Latif Khan ◽  
Shahzad Bhatti ◽  
Samina ◽  
Humaira Hamayun ◽  
Farah Enver ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Cross Sectional Study ◽  
Limiting Factor ◽  
Successful Pregnancy ◽  
Cross Sectional ◽  
The Impact

Abstract Introduction: Embryo transfer into the uterus during IVF/ICSI treatment is followed by embryo implantation, which depends on the receptivity of endometrium and is a pre-requisite for the initiation of a successful pregnancy. The endometrium proliferates under the hormonal influence (estrogen and progesterone), which is reflected by its thickness which is measurable by transvaginal ultrasonic scanning (TVS). The thickness of the endometrium less than 8 mm has been linked with implantation failure.11 Endometrial thickness of 9-14 mm on the day of progesterone supplementation has been shown to have a higher implantation rate. Thus, the implantation potential of a good embryo remains low during IVF treatment despite ovarian stimulation methods of assisted fertilization and improved culture condition.Objectives: This study was planned to determine the impact of endometrial thickness on ET and pregnancy rate in Pakistani patients undergoing IVF/ ICSI.Methods: This was a prospective, cross-sectional study conducted at a private fertility clinic (Lahore institute of fertility and endocrinology, LIFE) in Lahore, Pakistan, from January 2015 to December 2015. In this study, all those cases were included that reached oocytes pickup and embryo transfer (ET). Two protocols, agonist and antagonist, were used. In all cases, human menopausal gonadotrophin (hMG) and follicle-stimulating hormone (FSH) were used for stimulation. Follicles development was monitored; at least 3 follicles were reached at the diameter of ≥16mm.Results: Thickness of endometrium on decision day was calculated at various ranges concerning both groups and find pregnancy rates. When endometrial thickness was ≤ 6mm, PR was 2.22%, 7mm pregnancy rate (PR) was 1.11%, 8 mm PR was 3.33%, 9mm PR was 17.78%, 10mm PR was 33.33%, 11mm PR was 32.22%, and more than 11 mm PR was 10%. So, PR was higher from 2.22% to 10%. The overall pregnancy rate was 45.45%.Conclusion: The study concluded that endometrial thickness has significant effects on embryo transfer and outcomes.

scholarly journals The Association Between Serum Estradiol and Progesterone On the Same Day of FET and The Pregnancy Outcome; A Cross Sectional Study

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Pregnancy Rate ◽  
Pregnancy Outcome ◽  
Endometrial Thickness ◽  
Research Question ◽  
Cross Sectional Study ◽  
Clinical Pregnancy ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
The Impact

Research Question Precise timed synchronization between endometrium and the embryo is essential for high implantation and pregnancy rate, it is worthy to mention that endometrial thickness is not the only factor, E2 and P levels are also regularly monitored for endometrial receptivity. So, we decided to go for this study, to investigate the impact of serum E2 and P levels on the same day of embryo transfer on pregnancy outcomes for FET cycles. Design This was a retrospective cross sectional study for 402 FET cycles which conducted between April 2018 and May 2019. All participants started endometrial preparation for FET with 6 mg/day oral estradiol for 13 days. When endometrium reached 8 mm or greater, patients were initiated on both micronized vaginal and oral P treatment. On FET day, serum level of E2 and P were assessed. Then, transfer of PGT euploid embryos was performed. 12 days’ later pregnancy test was assessed, and then 4 weeks after FET date ultrasound was scheduled to check the viability and the clinical pregnancy. Results The mean E2 value was 931.41 ± 438.65 pg/ml, while mean P value was 8.47 ± 9.4 ng/ml. 240 out of 402 cases got pregnant (59.7%) while the clinical pregnancy rate was 53.9% with no correlation between serum (E2, P & E/P ratio) and the outcome. Conclusion Our results revealed that the association between E2 and P on FET day and the pregnancy outcome is still not proven and those markers can’t serve as predictors for the outcome.

scholarly journals Granulocyte Colony-Stimulating Factor Combined With Transcutaneous Electrical Acupoint Stimulation in Treatment of Unresponsive Thin Endometrium in Frozen Embryo Transfer Cycles

2021 ◽  
Vol 3 ◽  
Author(s):  
Linjiang Song ◽  
Qinxiu Zhang ◽  
Shaomi Zhu ◽  
Xudong Shan
Keyword(s):  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
Granulocyte Colony Stimulating Factor ◽  
Thin Endometrium ◽  
Treatment Groups ◽  
Stimulating Factor ◽  
Embryo Implantation Rate ◽  
Acupoint Stimulation

Objective: This trial was designed to assess the treatment effects of granulocyte colony-stimulating factor (G-CSF) and transcutaneous electrical acupoint stimulation (TEAS) on thin endometrium in frozen-thawed embryo transfer (FET) cycles.Methods: Ninety-nine patients with previous cancellations of embryo transfer were included, 56 of whom were prospectively treated with intrauterine perfusion of G-CSF in subsequent FET cycles. The selected patients were randomized into the G-CSF perfusion only group and the G-CSF perfusion combined with TEAS group. The other 43 patients were retrospectively included as controls.Results: Compared to previous cycles, endometrial thickness was statistically significantly increased in the two treatment groups (5.97 ± 0.60, 7.52 ± 0.56, 6.14 ± 0.52, and 7.66 ± 0.44; P = 0.00 and 0.00, respectively). The increases in endometrial thickness suggested that no statistically significant difference was found between the two treatment groups. The G-CSF with TEAS group suggested a higher embryo implantation rate than the G-CSF perfusion only and control groups (33.33 and 29.1% and 33.33 and 17.39%; P = 0.412 and 0.091, respectively). The G-CSF combined with TEAS group demonstrated nominally higher clinical and ongoing pregnancy rates than the G-CSF perfusion-only group and controls, though, the difference was not statistically significant.Conclusion: G-CSF has a potential role in improving endometrium thickness in patients with thin unresponsive endometrium in FET treatment cycles. In addition, when combined with TEAS, G-CSF perfusion treatment also improves the embryo implantation rate; however, randomized controlled trials are highly demanded to provide high-grade evidence regarding clinical pregnancy rate after G-CSF perfusion treatment.

scholarly journals Endometrial compaction and serum progesterone measurements at the day of embryo transfer cannot predict pregnancy outcomes in frozen-thaw embryo transfer cycles

2021 ◽  
Vol 12 (1) ◽  
pp. 407-415
Author(s):  
Dalal M. Al Jarrah ◽  
Manal Taha Al Obaidi ◽  
Itlal J. AL Asadi
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Pregnancy Outcomes ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
P Value ◽  
Ongoing Pregnancy ◽  
Ongoing Pregnancy Rate ◽  
Serum Progesterone ◽  
The Impact

Endometrial receptivity plays a basic role in successful embryo implantation and pregnancy outcomes and can be assessed by many of non-invasive markers. Our study evaluated the impact of two of these markers specifically serum progesterone and endometrial thickness at embryo transfer day in prediction pregnancy outcomes on (60) patients attempting medicated frozen embryo transfer (FET) cycles. All patients were received sequential estrogen & progesterone medications for endometrial preparation then submitted to measurements of endometrial thickness (EMT) by transvaginal-ultrasound (TV-US) & serums progesterone (P) analysis at the embryo transfer day, thereafter day 3 verified-thawed embryos grades (A±B) were transferred. Compacted (decreased) EMT was seen in 48.3% of patients with higher pregnancy rate (PR) of 58.6%t than non-compacted EMT (no change or increased) which was seen in 51.7% of patients with (PR) of 29.0%, (P value=0.021). However ongoing pregnancy rate (Ong PR) not differed significantly between both groups (44.8% in compacted vs 25.8% in non-compacted, P value=0.053), also the means of serum P not differed between pregnant and non-pregnant patients (P value=0.374). ROC curves for Ong PR prediction in relations to endometrial compaction & serum progesterone at embryo transfer day were poor (AUC= 0.630, & AUC=0.576, respectively). This study suggested that endometrial compaction or serum P levels measurements at embryo transfer day were poor predictors for ongoing pregnancy where any kind of EMT changes (decreased or not) seen after P administration not significantly affect pregnancy outcomes in frozen-thaw cycles of cleavage stage embryos transfer.

scholarly journals Survey of Relation between Midcycle Progesterone Level with IUI Cycles Success Rate

2020 ◽  
Vol 7 (4) ◽  
pp. 9
Author(s):  
Alieh Ghasemzadeh ◽  
Gilda Mostafavi ◽  
Mohammad Nouri ◽  
Parastoo Chaichi ◽  
Laya Farzadi ◽  
...  
Keyword(s):  
Success Rate ◽  
Pregnancy Rate ◽  
Assisted Reproductive Technology ◽  
Endometrial Thickness ◽  
Cross Sectional Study ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Progesterone Level ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Assisted reproductive technology is used routinely for treatment of infertile spouses. Previous studies reported conflicting results regarding effect of progesterone rise at the HCG injection day. The aim of current study is to evaluate the effects of mid cycle progesterone levels in IUI cycles. Methods: In this analytical cross-sectional study, the outcome of treatment in 200 IUI cycles were evaluated. Patients’ demographic findings, progesterone level at the day of HCG injection, number of follicles >16 mm, endometrial thickness and clinical pregnancy rate were recorded. For better evaluation, progesterone levels were divided to <0.5, 0.5-1.5 and >1.5 ng/dl. Results: Patients’ mean age was 29.70±4.38 years. The progesterone levels of <0.5, 0.5-1.5 and >1.5 ng/dl was detected in 24.5%, 56% and 19.5% of patients, respectively. The rate of clinical pregnancy was 27.5%. Cases with positive pregnancy had significantly lower progesterone levels (0.88±0.31 vs.1.11±0.80, p=0.04). The highest pregnancy rate was in progesterone levels 0.5-1.5 compared to levels <0.5 and >1.5 ng/dl (42% vs. 12.2% vs. 5.2%, p<0.001). There was no significant correlation between progesterone levels with endometrial thickness (r=-0.130, p=0.06) and number of follicles >16 mm(r=0.02, p=0.77). Conclusion: The results of current study showed that the increase in progesterone levels at the day of HCG injection accompanies with lower pregnancy rate. However, this increase has no correlation with number of mature follicles and endometrial thickness.

scholarly journals The efficacy of tamoxifen in the treatment of thin endometrium in frozen-thawed embryo transfer cycle

2020 ◽  
Author(s):  
Jingjuan Ji ◽  
Lihua Luo ◽  
Lingli Huang
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Hormone Replacement ◽  
Implantation Rate ◽  
Live Birth Rate ◽  
Tamoxifen Treatment ◽  
Induction Agent ◽  
Ongoing Pregnancy Rate ◽  
Thin Endometrium

Abstract Background: Thin endometrium is known to adversely affect reproductive performance. There is no agreement about a consensus treatment on thin endometrium. Tamoxifen(TAM) has a positive effect on endometrium when used as ovulation induction agent. Little information is available regarding its use in patients with thin endometrium during frozen-thaw embryo transfer (FET) cycles. This study was designed to evaluate the effectiveness of TAM on women with thin endometrium in frozen-thaw embryo transfer cycles. Methods: A total of 345 thin endometrium women were retrospectively analyzed during their FET cycles. Among them 190 received TAM protocol (TAM 20 mg per day for 5 days) and 155 hormone replacement therapy (HRT) protocol (estradiol val­erate 6 mg/d for 14 to 21days). Endometrial thickness and pregnancy outcome were compared between the two groups. Result(s): The endometrial thickness in TAM group was significantly higher compared with HRT group. The clinical pregnancy rate, implantation rate, ongoing pregnancy rate and live birth rate were significantly higher in TAM group than HRT group. Conclusion(s): In patients of recurrent thin endometrium, tamoxifen treatment in endometrium preparation may be a successful alternative approach

scholarly journals Impact of Transitory Hyperprolactinemia on Clinical Outcome of In Vitro Fertilization and Embryo Transfer

2012 ◽  
Vol 31 (1) ◽  
pp. 27-33
Author(s):  
Yi-ping Zhong ◽  
Xiao-ting Shen ◽  
Ying Ying ◽  
Hai-tao Wu ◽  
Jin Li ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Implantation Rate ◽  
Serum Prolactin ◽  
Close Monitoring ◽  
Vitro Fertilization ◽  
The Impact ◽  
Ivf Et

Impact of Transitory Hyperprolactinemia on Clinical Outcome of In Vitro Fertilization and Embryo Transfer This study aimed to evaluate the impact of serum prolactin concentration at the day of human chorionic gonadotropin (HCG) administration on the clinical outcome of in vitro fertilization and embryo transfer (IVF-ET). A total of 184 patients receiving the IVF-ET/ICSI-ET from October 2005 to March 2008 were retrospectively analyzed. Subjects were divided into four groups according to the serum prolactin concentration [<30 ng/mL (A), 30-60 ng/mL (B), 60-90 ng/mL (C), ≥90 ng/mL (D)] on the day of HCG administration during controlled ovarian stimulation (COS). In the Groups A, B, C and D, the implantation rate was 11.76%, 19.71%, 12.72% and 2.22%, respectively, and the pregnancy rate (PR) was 25.00%, 42.70%, 27.30% and 5.88%, respectively. The implantation rate and PR in the Group D were markedly lower than those in the remaining groups (P=0.011 and 0.009). During the COS, the serum prolactin concentration was dramatically elevated when compared with the baseline level leading to transient hyperprolactinemia. In addition, the implantation rate and pregnancy rate were significantly markedly decreased when the serum prolactin concentration was remarkably increased (≥90 ng/mL). To improve the clinical pregnancy rate of IVF-ET, close monitoring and appropriate intervention are needed for patients with an abnormal prolactin level during the COS.

scholarly journals Vaginal compared oral administration of estradiol in women with thin endometrium: A cross-sectional study

2020 ◽  
Author(s):  
Robab Davar ◽  
Masrooreh Hoseini ◽  
Lida Saeed
Keyword(s):  
Embryo Transfer ◽  
Endometrial Thickness ◽  
Cross Sectional Study ◽  
Estradiol Valerate ◽  
Sectional Study ◽  
Miscarriage Rate ◽  
Cross Sectional ◽  
Thin Endometrium ◽  
Oral Group ◽  
Early Miscarriage

Background: Endometrial thickness is regarded as an indicator of the receptivity of the endometrium. Patients preparing for frozen embryo transfer need some interventions in case their endometrium is thin. Objective: This study aimed to compare the clinical outcomes of oral administration of estradiol valerate with its vaginal type in women with inappropriate endometrial thickness. Materials and Methods: This cross-sectional study comprised of 79 women (cycles) who had undergone frozen-thawed embryo transfer. On the 13th day of the cycle, vaginal sonography was performed in case the thickness of the endometrium was < 7 mm; in the oral group, the patients continued using oral estradiol valerate tablet. However, in the vaginal group, the participants applied estradiol valerate tablet vaginally. Finally, the chemical and clinical pregnancy rate, also, early miscarriage rate were compared between the two groups. Results: The early miscarriage rate was lower in the vaginal group in comparison with the oral group (p = 0.040). Women in the vaginal group showed a lower rate of chemical pregnancy compared to the oral group, but this difference was not statistically significant (25.0 vs. 34.4%, p = 0.440). The rate of clinical pregnancy in the two groups was not statistically significant, although the vaginal group had a higher pregnancy rate (22.5% vs. 15.6%, p = 0.464), especially in women older than 34 years (37.5% vs. 11.1%, p = 0.355). Conclusion: Vaginal administration of estradiol tablet in women with thin endometrium leads to a lower rate of early miscarriage. Key words: Endometrium, Thickness, Frozen, Embryo transfer, Estradiol valerate.

P–315 Ultrasound diagnosis of adenomyosis: impact on pregnancy rate in ivf cycles with donated oocytes

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
C Exacoustos ◽  
L Loiudice ◽  
M Cosentino ◽  
D Galliano ◽  
F G Martire ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Implantation ◽  
Implantation Rate ◽  
First Trimester ◽  
Oocyte Donation ◽  
Control Group ◽  
Miscarriage Rate ◽  
Increased Risk ◽  
The Impact ◽  
Embryo Implantation Rate

Abstract Study question The aim was to evaluate in patients who underwent embryo transfer (ET) in an oocyte donation cycle, the impact of adenomyosis, diagnosed by transvaginal sonographic (TVS), on the implantation rate. Summary answer We observed a slightly higher miscarriage rate in the first trimester in patients with adenomyosis in particular in the diffuse type. What is known already What we know from literature is that there are pro studies such as Costello and Vercellini’s which show a reduced pregnancy rate and birth rate, and cons studies which find no effects at all of adenomyosis on IVF treatments. However, both show an increased risk of miscarriage and obstetric complications Study design, size, duration This prospective observational study involved a total of 72 patients: 33 with adenomyosis and 39 without adenomyosis from June 2019 to December 2020. All had a workup which included history, pelvic exam and 2/3D TVS scan which was saved as images, videoclips and volumes and stored. The off line evaluation was performed blind to IVF indication and outcomes by expert sonographer, who assessed the presence or absence of TVS signs of adenomyosis. Participants/materials, setting, methods All the patients aged ≤ 45 years old undergoing, for several personal problems, their first oocyte donation at IVI center Rome.Patients were divided into 2 groups according to findings on a baseline pre-treatment TVS: patients with and without adenomyosis. In the patients with adenomyosis, the disease was further classified according to type (diffuse,focal), localization (inner and outer myometrium) and extension inside the uterus (mild, moderate, severe) and correlated to pregnancy rate and outcome Main results and the role of chance A total of 72 patients were included in this study: 33 with adenomyosis and 39 without adenomyosis. The presence, type and degree of adenomyosis doesn’t show a correlation to embryo implantation rate (64.1% in the control group vs 63.6% in adenomyosis group). However we found an increased risk of early miscarriage in the patients with adenomyosis ( 12% in the control group vs 23.8% in adenomyosis group). Women with adenomyosis that infiltrated only the external myometrium showed a lower pregnancy rate (40%) compared to those who had the involvement of only the inner myometrium (77,7%). The presence of ultrasound findings of focal disease was associated with a lower pregnancy rate (53,3%) compared to the diffuse disease (72,2%); We observed a slightly higher miscarriage rate in the first trimester in patients with adenomyosis in particular in the diffuse type .The presence, type and degree of adenomyosis doesn’t show a correlation to embryo implantation rate. Limitations, reasons for caution Most of the patients included in our study has an age &gt; 40. This could determine an increased number of high-risk pregnancies. Wider implications of the findings: Results of this study may be used to evaluate the impact of different medical or surgical treatment in women with adenomyosis undergoing IVF. Trial registration number Not applicable

Endometrial thickness measurements among Asherman syndrome patients prior to embryo transfer

2020 ◽  
Vol 35 (12) ◽  
pp. 2746-2754
Author(s):  
Peter Movilla ◽  
Jennifer Wang ◽  
Tammy Chen ◽  
Blanca Morales ◽  
Joyce Wang ◽  
...  
Keyword(s):  
Pregnancy Rate ◽  
Embryo Transfer ◽  
Conflicts Of Interest ◽  
Endometrial Thickness ◽  
Multivariable Analysis ◽  
Small Sample ◽  
Clinical Pregnancy ◽  
Clinical Pregnancy Rate ◽  
The Mean ◽  
The Impact

Abstract STUDY QUESTION Is there an association between endometrial thickness (EMT) measurement and clinical pregnancy rate among Asherman syndrome (AS) patients utilizing IVF and embryo transfer (ET)? SUMMARY ANSWER EMT measurements may not be associated with successful clinical pregnancy among AS patients undergoing IVF. WHAT IS KNOWN ALREADY Clinical pregnancy rate after IVF is significantly lower in patients with a thin endometrium, defined as a maximum EMT of &lt;7 mm. However, AS patients often have a thin EMT measurement due to intrauterine scarring, with a paucity of data and no guidance on what EMT cutoff is appropriate when planning an ET among these patients. STUDY DESIGN, SIZE, DURATION This is a retrospective cohort study of 45 AS patients treated at a specialized advanced hysteroscopic clinic from 1 January 2015, to 1 March 2019. PARTICIPANTS/MATERIALS, SETTING, METHODS Review of EMT measurements prior to a total of 90 ETs, among 45 AS patients. The impact of the maximum EMT measurement prior to ET on clinical pregnancy rate was analyzed. MAIN RESULTS AND THE ROLE OF CHANCE A total of 25/45 (55.6%) AS patients ultimately went on to have ≥1 clinical pregnancy following a mean ± SD of 2.00 ± 1.26 ET attempts. There was a total of 90 ETs among the 45 AS patients, with 29/90 (32.2%) ETs resulting in a clinical pregnancy. Younger patient age (P = 0.05) and oocyte donation (P = 0.01) were the only variables identified to be significant predictors for a positive clinical pregnancy outcome on bivariate analysis. The mean EMT measurement prior to all ETs among AS patients was 7.5 ± 1.6 mm. EMT measurement prior to ET did not predict a positive clinical pregnancy on either bivariate (P = 0.84) or multivariable analysis (odds ratio 0.91, P = 0.60). 31.8% of EMT measurements measured &lt;7.0 mm. In this small cohort, no difference in the clinical pregnancy rate was detected when comparing ETs with EMT measurements of &lt;7.0 mm versus ≥7.0 mm (P = 0.83). The mean EMT measurement decreased with increasing AS disease severity; 8.0 ± 1.6 mm for mild disease, 7.0 ± 1.4 mm for moderate disease and 5.4 ± 0.1 mm for severe disease. LIMITATIONS, REASONS FOR CAUTION Our small sample size limits our ability to draw any definitive conclusions. In addition, patients utilized various infertility clinics. This limits our ability to evaluate the consistency of EMT measurements and the IVF care that was received. WIDER IMPLICATIONS OF THE FINDINGS EMT measurement cutoff values should be used with caution if canceling a scheduled ET in AS patients. STUDY FUNDING/COMPETING INTEREST(S) This study was not funded. K.I. reports personal fees from Karl Stroz and personal fees from Medtronics outside the submitted work. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.

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