Association between endometrial thickness in oocyte donation cycles and pregnancy success rates
Hans Arce A , Esther Velilla A C and Marisa López-Teijón A BA Institut Marquès Obstetricia i Ginecologia, S.L.P, C/Capitán Arenas 38-40 Ppal 2 Dcha, 08034 Barcelona, Spain.
B Fundación Leonardo Marques, Passeig Manel Girona 33, 08034 Barcelona, Spain.
C Corresponding author. Email: esthervelilla@pgdcem.com
Reproduction, Fertility and Development 28(9) 1288-1294 https://doi.org/10.1071/RD14459
Submitted: 20 November 2014 Accepted: 8 January 2015 Published: 24 February 2015
Abstract
Endometrial receptivity is a primary concern for embryo implantation success in fertility treatments. The present study was a retrospective analysis of 4070 cycles with donor oocytes and hormone-replacement therapy. Endometrial thickness was assessed once with transvaginal ultrasound. Patients were allowed to continue when endometrial thickness was ≥5 mm and had triple line morphology. Pregnancy rates, the number of gestational sacs and miscarriage rates were analysed in relation to endometrium status. Regression models were used to analyse associations, taking the day of embryo transfer into account. All patient parameters were homogeneous. Mean endometrial thickness was 7.24 ± 1.66 mm, the mean number of embryos transferred was 2.04 ± 0.43, the pregnancy rate was 48.06% and sacs were present in 42.3% of cycles. There were no significant differences in pregnancy rates, number of gestational sacs and miscarriage rates for different endometrial thickness measurements. The present study is, to our knowledge, the largest study evaluating the role of endometrial thickness in oocyte donation cycles. Endometrial thickness >5 mm is a reasonable parameter for determining treatment success, and once it is observed in a single ultrasonographic evaluation there is no need for subsequent monitoring and embryo transfer can be scheduled over the following 1–16 days, because the results are not compromised. This may lead to a significant reduction in time and cost in fertility clinics.
Additional keywords: embryo transfer, endometrial receptivity, fertility treatment, hormone-replacement therapy, miscarriage rate.
References
Al-Ghamdi, A., Coskun, S., Al-Hassan, S., Al-Rejjal, R., and Awartani, K. (2008). The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reprod. Biol. Endocrinol. 6, 37.| The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome.Crossref | GoogleScholarGoogle Scholar | 18764940PubMed |
Alpha Scientists in Reproductive Medicine and ESHRE Special Interest Group of Embryology (2011). The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting. Hum. Reprod. 26, 1270–1283.
| The Istanbul consensus workshop on embryo assessment: proceedings of an expert meeting.Crossref | GoogleScholarGoogle Scholar | 21502182PubMed |
Amir, W., Micha, B., Ariel, H., Liat, L. G., Jehoshua, D., and Adrian, S. (2007). Predicting factors for endometrial thickness during treatment with assisted reproductive technology. Fertil. Steril. 87, 799–804.
| Predicting factors for endometrial thickness during treatment with assisted reproductive technology.Crossref | GoogleScholarGoogle Scholar | 17207799PubMed |
Aydin, T., Kara, M., and Nurettin, T. (2013). Relationship between endometrial thickness and in vitro fertilization-intracytoplasmic sperm injection outcome. Int. J. Fertil. Steril. 7, 29–34.
| 24520460PubMed |
Balaban, B., and Urman, B. (2003). Embryo culture as a diagnostic tool. Reprod. Biomed. Online 7, 671–682.
| Embryo culture as a diagnostic tool.Crossref | GoogleScholarGoogle Scholar | 14748966PubMed |
Barker, M. A., Boehnlein, L. M., Kovacs, P., and Lindheim, S. R. (2009). Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles. J. Assist. Reprod. Genet. 26, 243–249.
| Follicular and luteal phase endometrial thickness and echogenic pattern and pregnancy outcome in oocyte donation cycles.Crossref | GoogleScholarGoogle Scholar | 19548081PubMed |
Bourgain, C., and Devroey, P. (2003). The endometrium in stimulated cycles for IVF. Hum. Reprod. Update 9, 515–522.
| The endometrium in stimulated cycles for IVF.Crossref | GoogleScholarGoogle Scholar | 14714588PubMed |
Dain, L., Bider, D., Levron, J., Zinchenko, V., Westler, S., and Dirnfeld, M. (2013). Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation? Fertil. Steril. 100, 1289–1295.
| Thin endometrium in donor oocyte recipients: enigma or obstacle for implantation?Crossref | GoogleScholarGoogle Scholar | 23954352PubMed |
De Geyter, C., Schmitter, M., De Geyter, M., Nieschlag, E., Holzgreve, W., and Schneider, H. P. (2000). Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1,186 infertile women. Fertil. Steril. 73, 106–113.
| Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1,186 infertile women.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2Fps1arsQ%3D%3D&md5=8622f8e7d4319e881bed28acd7e5aafeCAS | 10632422PubMed |
de Ziegler, D. (2008). [Quality of endometrial preparation.] J. Gynecol. Obstet. Biol. Reprod. (Paris) 37, S30–S33.
| 18786467PubMed |
Dessolle, L., Darai, E., Cornet, D., Rouzier, R., Coutant, C., Mandelbaum, J., and Antoine, J. M. (2009). Determinants of pregnancy rate in the donor oocyte model: a multivariate analysis of 450 frozen–thawed embryo transfers. Hum. Reprod. 24, 3082–3089.
| Determinants of pregnancy rate in the donor oocyte model: a multivariate analysis of 450 frozen–thawed embryo transfers.Crossref | GoogleScholarGoogle Scholar | 19726449PubMed |
Dietterich, C., Check, J. H., Choe, J. K., Nazari, A., and Lurie, D. (2002). Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer. Fertil. Steril. 77, 781–786.
| Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer.Crossref | GoogleScholarGoogle Scholar | 11937134PubMed |
Evans, J., Hannan, N. J., Hincks, C., Rombauts, L. J., and Salamonsen, L. A. (2012). Defective soil for a fertile seed? Altered endometrial development is detrimental to pregnancy success. PLoS ONE 7, e53098.
| Defective soil for a fertile seed? Altered endometrial development is detrimental to pregnancy success.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXptVWmtg%3D%3D&md5=f840448dbe27166f18181e079a13579eCAS | 23300868PubMed |
Garcia-Velasco, J. A., Isaza, V., Caligara, C., Pellicer, A., Remohi, J., and Simon, C. (2003). Factors that determine discordant outcome from shared oocytes. Fertil. Steril. 80, 54–60.
| Factors that determine discordant outcome from shared oocytes.Crossref | GoogleScholarGoogle Scholar | 12849801PubMed |
Gonen, Y., and Casper, R. F. (1990). Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF). J. In Vitro Fert. Embryo Transf. 7, 146–152.
| Prediction of implantation by the sonographic appearance of the endometrium during controlled ovarian stimulation for in vitro fertilization (IVF).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3czjvVylug%3D%3D&md5=3d2718d741fd01cedf2d8a381322a42cCAS | 2199588PubMed |
Gupta, P., Banker, M., Patel, P., and Joshi, B. (2012). A study of recipient related predictors of success in oocyte donation program. J. Hum. Reprod. Sci. 5, 252–257.
| A study of recipient related predictors of success in oocyte donation program.Crossref | GoogleScholarGoogle Scholar | 23531511PubMed |
Hofmann, G. E., Thie, J., Scott, R. T., and Navot, D. (1996). Endometrial thickness is predictive of histologic endometrial maturation in women undergoing hormone replacement for ovum donation. Fertil. Steril. 66, 380–383.
| 1:STN:280:DyaK28zlt1Khsg%3D%3D&md5=27d95ff68e0ec69e2fccc0095d2c99b8CAS | 8751733PubMed |
Isaacs, J. D., Wells, C. S., Williams, D. B., Odem, R. R., Gast, M. J., and Strickler, R. C. (1996). Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with menotropins alone. Fertil. Steril. 65, 262–266.
| 8566245PubMed |
Kasius, A., Smit, J. G., Torrance, H. L., Eijkemans, M. J., Mol, B. W., Opmeer, B. C., and Broekmans, F. J. (2014). Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum. Reprod. Update 20, 530–541.
| Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar | 24664156PubMed |
Laasch, C., and Puscheck, E. (2004). Cumulative embryo score, not endometrial thickness, is best for pregnancy prediction in IVF. J. Assist. Reprod. Genet. 21, 47–50.
| Cumulative embryo score, not endometrial thickness, is best for pregnancy prediction in IVF.Crossref | GoogleScholarGoogle Scholar | 15186021PubMed |
Labarta, E., Martinez-Conejero, J. A., Alama, P., Horcajadas, J. A., Pellicer, A., Simon, C., and Bosch, E. (2011). Endometrial receptivity is affected in women with high circulating progesterone levels at the end of the follicular phase: a functional genomics analysis. Hum. Reprod. 26, 1813–1825.
| Endometrial receptivity is affected in women with high circulating progesterone levels at the end of the follicular phase: a functional genomics analysis.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3MXnvFantLY%3D&md5=4276f6b769d9f5290e843bff4df684f9CAS | 21540246PubMed |
Lebovitz, O., and Orvieto, R. (2014). Treating patients with ‘thin’ endometrium: an ongoing challenge. Gynecol. Endocrinol. 30, 409–414.
| Treating patients with ‘thin’ endometrium: an ongoing challenge.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC2cXoslCit7s%3D&md5=e80e143f0aedcab4b6473cfd280d8de6CAS | 24693854PubMed |
McWilliams, G. D., and Frattarelli, J. L. (2007). Changes in measured endometrial thickness predict in vitro fertilization success. Fertil. Steril. 88, 74–81.
| Changes in measured endometrial thickness predict in vitro fertilization success.Crossref | GoogleScholarGoogle Scholar | 17239871PubMed |
Momeni, M., Rahbar, M. H., and Kovanci, E. (2011). A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles. J. Hum. Reprod. Sci. 4, 130–137.
| A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles.Crossref | GoogleScholarGoogle Scholar | 22346080PubMed |
Navot, D., Bergh, P. A., Williams, M., Garrisi, G. J., Guzman, I., Sandler, B., Fox, J., Schreiner-Engel, P., Hofmann, G. E., and Grunfeld, L. (1991). An insight into early reproductive processes through the in vivo model of ovum donation. J. Clin. Endocrinol. Metab. 72, 408–414.
| An insight into early reproductive processes through the in vivo model of ovum donation.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3M7itlegtQ%3D%3D&md5=41b42091d4819ff766c9985d7855b14cCAS | 1991811PubMed |
Noyes, N., Hampton, B. S., Berkeley, A., Licciardi, F., Grifo, J., and Krey, L. (2001). Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis. Fertil. Steril. 76, 92–97.
| Factors useful in predicting the success of oocyte donation: a 3-year retrospective analysis.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3MzosVKisw%3D%3D&md5=ab808fb09f608f25468ca9fceeb3363dCAS | 11438325PubMed |
Remohí, J., Ardiles, G., Garcia-Velasco, J. A., Gaitan, P., Simon, C., and Pellicer, A. (1997). Endometrial thickness and serum oestradiol concentrations as predictors of outcome in oocyte donation. Hum. Reprod. 12, 2271–2276.
| Endometrial thickness and serum oestradiol concentrations as predictors of outcome in oocyte donation.Crossref | GoogleScholarGoogle Scholar | 9402294PubMed |
Requena, A., Cruz, M., Bosch, E., Meseguer, M., and Garcia-Velasco, J. A. (2014). High progesterone levels in women with high ovarian response do not affect clinical outcomes: a retrospective cohort study. Reprod. Biol. Endocrinol. 12, 69.
| High progesterone levels in women with high ovarian response do not affect clinical outcomes: a retrospective cohort study.Crossref | GoogleScholarGoogle Scholar | 25064138PubMed |
Richter, K. S., Bugge, K. R., Bromer, J. G., and Levy, M. J. (2007). Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil. Steril. 87, 53–59.
| Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos.Crossref | GoogleScholarGoogle Scholar | 17081537PubMed |
Schild, R. L., Knobloch, C., Dorn, C., Fimmers, R., van der Ven, H., and Hansmann, M. (2001). Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow. Fertil. Steril. 75, 361–366.
| Endometrial receptivity in an in vitro fertilization program as assessed by spiral artery blood flow, endometrial thickness, endometrial volume, and uterine artery blood flow.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3M7ktlCguw%3D%3D&md5=f7d82bda61d31a6508fe04f2215ded23CAS | 11172840PubMed |
Shapiro, H., Cowell, C., and Casper, R. F. (1993). The use of vaginal ultrasound for monitoring endometrial preparation in a donor oocyte program. Fertil. Steril. 59, 1055–1058.
| 1:STN:280:DyaK3s3lt1WjsA%3D%3D&md5=b84e8a39301830841e6445d0cfb3ca9aCAS | 8486173PubMed |
Sharara, F. I., Lim, J., and McClamrock, H. D. (1999). Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration. J. Assist. Reprod. Genet. 16, 523–528.
| Endometrial pattern on the day of oocyte retrieval is more predictive of implantation success than the pattern or thickness on the day of hCG administration.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3c%2Fkt1ygtg%3D%3D&md5=11a4da94a82fd06327f2e42593508f51CAS | 10575580PubMed |
Simón, C., Cano, F., Valbuena, D., Remohi, J., and Pellicer, A. (1995). Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Hum. Reprod. 10, 2432–2437.
| Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients.Crossref | GoogleScholarGoogle Scholar | 8530680PubMed |
Vernaeve, V., Reis Soares, S., Budak, E., Bellver, J., Remohi, J., and Pellicer, A. (2007). [Clinical factors associated with the outcome of oocyte donation.] Gynecol. Obstet. Fertil. 35, 1015–1023.
| [Clinical factors associated with the outcome of oocyte donation.]Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2snotlygtA%3D%3D&md5=2518933cc3665dd7b1e57735e663b253CAS | 17905636PubMed |
Wu, Y., Gao, X., Lu, X., Xi, J., Jiang, S., Sun, Y., and Xi, X. (2014). Endometrial thickness affects the outcome of in vitro fertilization and embryo transfer in normal responders after GnRH antagonist administration. Reprod. Biol. Endocrinol. 12, 96.
| Endometrial thickness affects the outcome of in vitro fertilization and embryo transfer in normal responders after GnRH antagonist administration.Crossref | GoogleScholarGoogle Scholar | 25296555PubMed |
Yuval, Y., Lipitz, S., Dor, J., and Achiron, R. (1999). The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization. Hum. Reprod. 14, 1067–1071.
| The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3jslGquw%3D%3D&md5=de63a064f6f5b86912bda10531026393CAS | 10221242PubMed |
Zenke, U., and Chetkowski, R. J. (2004). Transfer and uterine factors are the major recipient-related determinants of success with donor eggs. Fertil. Steril. 82, 850–856.
| Transfer and uterine factors are the major recipient-related determinants of success with donor eggs.Crossref | GoogleScholarGoogle Scholar | 15482759PubMed |
Zhang, X., Chen, C. H., Confino, E., Barnes, R., Milad, M., and Kazer, R. R. (2005). Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil. Steril. 83, 336–340.
| Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer.Crossref | GoogleScholarGoogle Scholar | 15705371PubMed |
Zhao, J., Zhang, Q., and Li, Y. (2012). The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles. Reprod. Biol. Endocrinol. 10, 100.
| The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles.Crossref | GoogleScholarGoogle Scholar | 23190428PubMed |
Zhao, J., Zhang, Q., Wang, Y., and Li, Y. (2014). Endometrial pattern, thickness and growth in predicting pregnancy outcome following 3319 IVF cycle. Reprod. Biomed. Online 29, 291–298.
| Endometrial pattern, thickness and growth in predicting pregnancy outcome following 3319 IVF cycle.Crossref | GoogleScholarGoogle Scholar | 25070912PubMed |