THE EFFECT OF ENDOMETRIAL THICKNESS ON THE OUTCOME OF ASSISTED REPRODUCTIVE TECHNOLOGY PROGRAMS. REVIEW.
Introduction. A thin endometrium recorded on ultrasound during ovarian stimulation, according to literature data, is associated with a decrease in the frequency of pregnancy after in vitro fertilization (IVF), even in the absence of previous surgical interventions in the uterine cavity or an infectious endometrial lesion. This literature review is devoted to the study of the effect of endometrial thickness on the outcomes of assisted reproductive technologies.
The aim. To study the experience of foreign authors in studying the correlation of the outcomes of IVF programs with the thickness of the endometrium at the time of embryo transfer.
Search strategy. The literature search was carried out using PubMed, Google Scholar, Medline databases over the past 10 years, and several sources from 1989, 1993 and 1996 containing conceptual information were also included. The search was performed by keywords: «endometrial thickness», «thin endometrium», «assisted reproductive technologies», «in vitro fertilization». English-language articles evaluating the correlation between the thickness of the endometrium and the frequency of pregnancy, maternal and perinatal outcomes in women who underwent IVF were selected.
Results and conclusions. Analysis of these studies has shown that there is a natural correlation between the thickness of the endometrium and the performance indicators of assisted reproductive technology programs. The thin endometrium reduces the frequency of clinical pregnancy, and also adversely affects the outcome of pregnancy itself, increasing the risks of miscarriage and premature birth.
Yuliya V. Zabrodina1, https://orcid.org/0000-0001-8972-0300
Gainyl U. Akhmedyanova1, https://orcid.org/0000-0002-5410-7781
Zaituna G. Khamidullina1, https://orcid.org/0000-0002-0902-5269
1 NJSC "Astana Medical University", Department of Obstetrics and Gynecology No.1,
Astana, Republic of Kazakhstan.
1. Alam V., Bernardini L. et al. A prospective study of echographic endometrial characteristics and pregnancy rates during hormonal replacement cycles // J Assist Reprod Genet 1993. 10: 215–19
2. Azumaguchi A., Henmi H., Ohnishi H., et al. Role of dilatation and curettage performed for spontaneous or induced abortion in the etiology of endometrial thinning // J Obstet Gynaecol Res, 2017. 43 (3): 523–9
3. Bakos O., Lundkvist O., Bergh T. Transvaginal sonographic evaluation of endometrial growth and texture in spontaneous ovulatory cycles – a descriptive study // Hum Reprod. 1993. 8:799–806.
4. Basir G.S., O W.S., So W.W., et al. Evaluation of cycle-to-cycle variation of endometrial responsiveness using transvaginal sonography in women undergoing assisted reproduction // Ultrasound Obstet Gynecol. 2002. 19:484–9.
5. Bozdag G., Esinler I., Yarali H. The impact of endometrial thickness and texture on intracytoplasmic sperm injection outcome // J Reprod Med. 2009. 54 (5): 303–11.
6. Bu Z., Sun Y. The impact of endometrial thickness on the day of human chorionic gonadotrophin (hCG): administration on ongoing pregnancy rate in patients with different ovarian response // PLoS One. 2015. 10(12). eCollection 2015.
7. Bu Z., Wang K., Dai W. et al. Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles // Gynecol Endocrinol. 2016. 32 (7): 524–8.
8. Casper R. It's time to pay attention to the endometrium // Fertil Steril. 2011. 96: 519–21.
9. Check J.H., Cohen R. Live fetus following embryo transfer in a woman with diminish egg reserve whose maximal endometrial thickness was less than 4 mm // Clin Exp Obstet Gynecol. 2011. 38: 330–2.
10. Check J. The importance of sonographic endometrial parameters in influencing success following embryo transfer in the modern era and therapeutic options – part 1: the importance of late proliferative phase endometrial thickness // Clin Exp Obstet Gynecol. 2011. 38 (3): 197–200
11. Chen S., Wu F., Luo C. et al. Combined analysis of endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer: a retrospective cohort study // Reprod Biol Endocrinol. 2010. 24-30
12. Corbacioğlu A., Baysal B. Effects of endometrial thickness and echogenic pattern on assisted reproductive treatment outcome // Clin Exp Obstet Gynecol. 2009. 36 (3): 145–7.
13. Dain L., Bider D., Levron J., Zinchenko V., Westler S., Dirnfeld M. Thin endometrium in donor oocyte recipients: Enigma or obstacle for implantation? // Fertil Steril. 2013. 100:1289-95.
14. Danhof N.A., Eekelen R., Repping S., Mol B.W., Veen F., Wely M., et al. Endometrial thickness as a biomarker for ongoing pregnancy in IUI for unexplained subfertility: a secondary analysis // Hum Reprod Open 2020. 2020:hoz024.
15. Dehbashi S., Parsanezhad M.E., Alborzi S., Zarei A. Effect of clomiphene citrate on endometrium thickness and echogenic patterns // Int J Gynaecol Obstet. 2003. 6:49-53.
16. Dix E., Check J.H. Successful pregnancies following embryo transfer despite very thin late proliferative endometrium // Clin Exp Obstet Gynecol. 2010. 37: 15–6.
17. El-Toukhy T., Coomarasamy A., Khairy M., et al. The relationship between endometrial thickness and outcome of medicated frozen embryo replacement cycles // Fertil Steril. 2008. 89: 832–9.
18. Esmailzadeh S., Faramarzi M. Endometrial thickness and pregnancy outcome after intrauterine insemination // Fertil Steril. 2007. 88:432–437.
19. Fanchin R. Assessing uterine receptivity in 2001: ultrasonographic glances at the new millennium // Ann N Y Acad Sci. 2001. 943, 185-202.
20. Fang R., Cai L., Xiong F. et al. The effect of endometrial thickness on the day of hCG administration on pregnancy outcome in the first fresh IVF/ICSI cycle // Gynecol Endocrinol. 2016. 32 (6): 473–6
21. Gao G., Cui X., Li S., Ding P., Zhang S., Zhang Y. Endometrial thickness and IVF cycle outcomes: a meta-analysis // Reprod Biomed Online. 2020. 40:124–33.
22. Gleicher N., Vidali A., Barad D.H. Successful treatment of unresponsive thin endometrium // Fertil Steril. 2011. 95:2123.e13–17.
23. Gonen Y., Casper R.F., Jacobson W., Blankier J. Endometrial thickness and growth during ovarian stimulation: a possible predictor of implantation in in vitro fertilization // Fertil Steril. 1989. 52:446–50.
24. Grow D.R., Iromloo K. Oral contraceptives maintain a very thin endometrium before operative hysteroscopy // Fertil Steril. 2006. 85:204–207.
25. Hershko-Klement A., Tepper R. Ultrasound in assisted reproduction: a call to fill the endometrial gap // Fertil Steril. 2016 Jun. 105(6):1394-1402.e4.
26. Hock D.L., Bohrer M.K., Ananth C.V., Kemmann E. Sonographic assessment of endometrial pattern and thickness in patients treated with clomiphene citrate, human menopausal gonadotropins, and intrauterine insemination // Fertil Steril. 1997. 68:242–245.
27. Isaacs Jr. JD., Wells C.S., Williams D.B., et al. Endometrial thickness is a valid monitoring parameter in cycles of ovulation induction with metropins alone // Fertil Steril. 1996. 65:262–6.
28. Kasius A., Smit J.G., Torrance H.L., Eijkemans M.J., Mol B.W., Opmeer B.C., et al. Endometrial thickness and pregnancy rates after IVF: A systematic review and meta-analysis // Hum Reprod Update. 2014. 20:530-41.
29. Kehila M., Kebaili S., Bougmiza I. et al. Endometrial thickness in in vitro fertilization. A study of 414 cases // Tunis Med. 2010. 88 (12): 928–32.
30. Khan M., Shaikh A., Ratnani R. Ultrasonography and Doppler Study to Predict Uterine Receptivity in Infertile Patients Undergoing Embryo Transfer // J Obstet Gynaecol India. 2016. 66 (Suppl. 1): 377–82
31. Kovacs P., Matyas S., Boda K., Kaali S.G., The effect of endometrial thickness on IVF/ICSI outcome // Hum Reprod. 2003. 18, 2337-2341.
32. Kumbak B., Erden H.F.., Tosun S, Akbas H., Ulug U., Bahçeci M. Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm // Reprod Biomed Online. 2009. 18:79-84.
33. Liao S., Wang R., Hu C., Pan W., Pan W., Yu D., et al. Analysis of endometrial thickness patterns and pregnancy outcomes considering 12,991 fresh IVF cycles // BMC Med Inform Decis Mak. 2021. 21:1–13.
34. Liu K.E., Hartman M., Hartman A., Luo Z.C., Mahutte N. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: an analysis of over 40,000 embryo transfers // Hum Reprod. 2018. 33:1883–8.
35. Lutjen P., Trounson A., Leeton J., et al. The establishment and maintenance of pregnancy using in vitro fertilization and embryo donation in a patient with primary ovarian failure // Nature. 1984. 307: 174–5: 998–1004.
36. Ma N., Chen L., Dai W. et al. Influence of endometrial thickness on treatment outcomes following in vitro fertilization/intracytoplasmic sperm injection // Reprod Biol Endocrinol. 2017. 15:5
37. Madsen B.L., Giudice L., Donaldson S.S. Radiation-induced premature menopause: a misconception // Int J Radiat Oncol Biol Phys. 1995. 32:1461-4.
38. Mahajan N., Sharma S. The endometrium in assisted reproductive technology: How thin is thin? // J Hum Reprod Sci. 2016 Jan-Mar. 9(1):3-8.
39. Mahutte N., Hartman M., Meng L., Lanes A., Luo Z.C., Liu K.E. Optimal endometrial thickness in fresh and frozen-thaw in vitro fertilization cycles: an analysis of live birth rates from 96,000 autologous embryo transfers // Fertil Steril. 2022. 117:792–800.
40. Makker A., Singh M.M. Endometrial receptivity: clinical assessment in relation to fertility, infertility, and antifertility // Med Res Rev. 2006. 26:699–746.
41. McWilliams G.D., Frattarelli J.L. Changes in measured endometrial thickness predict in vitro fertilization success // Fertil Steril. 2007. 88: 74–81.
42. Meybodi M., Afkhami-Ardekani M., Rashidi M. et al. Prevalence of abnormal serum alanine aminotransferase levels in type 2 diabetic patients in Iran // Pak J Biol Sci. 2008. 11 (18): 2274–7.
43. Miwa I., Tamura H., Takasaki A., et al. Pathophysiologic features of ‘‘thin’’ endometrium // Fertil Steril. 2009. 91. 998-1004.
44. Noyes N., Liu H., Sultan K. et al. Endometrial thickness appears to be a significant factor in embryo implantation in in-vitro fertilization // Human Reprod. 1995. 10: 919–22.
45. Onogi S., Ezoe K., Nishihara S., Fukuda J., Kobayashi T., Kato K. Endometrial thickness on the day of the LH surge: an effective predictor of pregnancy outcomes after modified natural cycle-frozen blastocyst transfer // Hum Reprod Open. 2020. 2020:hoaa060.
46. Orazov M.R., Radzinsky V. E., Khamoshina M.B., Kaygorodova L.A., Toktar L.R., Pokul L.V., Tulupova M.S. The secrets of reproductive failure: a «thin» endometrium // Reproduction problems. 2018. 2 (35). 7-17
47. Patel J.A., Patel A.J., Banker J.M., Shah S.I., Banker M. Effect of endometrial thickness and duration of estrogen supplementation on in vitro fertilization-intracytoplasmic sperm injection outcomes in fresh ovum/embryo donation cycles // J Hum Reprod Sci. 2021. 14:167–74.
48. Paulson R.J. Hormonal induction of endometrial receptivity // Fertil Steril. 2011. 213:530–5.
49. Pedri S., Lico D., Di Cello A., D’Alessandro P., Vaiarelli A., Alviggi E. et al. Thin endometrium in patient undergoing Assisted Reproductive Technology: pathogenesis and treatment // Current January. 2017. 3(1):1-1.
50. Quaas A.M., Gavrizi S.Z., Peck J.D., Diamond M., Legro R., Robinson R., et al. Endometrial thickness after ovarian stimulation with gonadotropin, clomiphene, or letrozole for unexplained infertility, and association with treatment outcomes // Fertil Steril. 2021. 115:213–20.
51. Scioscia M., Lamanna G., Lorusso F. et al. Characterization of endometrial growth in proliferative and early luteal phase in IVF cycles // Reprod Biomed Online. 2009. 18:73-8.
52. Shapiro H., Cowell C., Casper R.F. The use of vaginal ultrasound for monitoring endometrial preparation in a donor oocyte program // Fertil Steril. 1993. 59:1055
53. Sher G., Herbert C., Maassarani G., Jacobs M.H. Assessment of the late proliferative phase endometrium by ultrasonography in patients undergoing in vitro fertilization and embryo transfer (IVF/ET) // Hum Reprod. 1991. 6(2): 232-37
54. Shufaro Y., Simon A., Laufer N., Fatum M. Thin unresponsive endometrium-a possible complication of surgical curettage compromising ART outc ome // J Ass Reprod Genet. 2008. 25: 421–5.
55. Simeonov M., Sapir O., Lande Y., Ben-Haroush A., Oron G., Shlush E., et al. The entire range of trigger-day endometrial thickness in fresh IVF cycles is independently correlated with live birth rate // Reprod Biomed Online. 2020. 41: 239–47.
56. Sunderam S., Kissin D., Crawford S., Folger S., Jamieson D., et al., Assisted reproductive technology surveillance--United States // MMWR Surveill Summ. 2014. 21. 63(10):1-28.
57. United Nations and Department of Economic and Social Affairs Population Division // Reproductive Health Policies. 2017 Data Booklet (ST/ESA/SER.A/396).
58. Wang L., Qiao J., Li R., Zhen X., Liu Z. Role of endometrial blood flow assessment with color Doppler energy in predicting pregnancy outcome of IVF-ET cycles // Reprod Biol Endocrinol. 2010. 8, 122.
59. Weiss N.S., van Vliet M.N., Limpens J., Hompes P.G., Lambalk C.B., Mochtar M.H., et al. Endometrial thickness in women undergoing IUI with ovarian stimulation. How thick is too thin? A systematic review and meta-analysis // Hum Reprod. 2017. 32:1009–18.
60. Weissman A., Gotlieb L., Casper R.F. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in in vitro fertilization program // Fertil Steril. 1999. 71:147–9.
61. Wu Y., Gao X., Lu, X., X J., Jiang S., Sun Y., Xi X. Endometrial thickness affects the outcome of in vitro fertilization and embryo transfer in normal responders after GnRH antagonist administration // Reprod Biol Endocrinol. 2014. 12, 96.
62. Xiao Z., Zhou X., Xu W., Yang, J., Xie Q., Natural cycle is superior to hormone replacement therapy cycle for vitrificated-preserved frozen-thawed embryo transfer // Syst Biol Reprod Med. 2012. 58, 107-112.
63. Yuan X., Saravelos S., Wang Q. et al., Endometrial thickness as a predictor of pregnancy outcomes in 10787 fresh IVF-ICSI cycles // Reprod Biomed Online. 2016. 33 (2): 197–205.
64. Zegers-Hochschild F., Dyer S, Chambers GM, Adamson GD, Banker M, De Mouzon J, Ishihara O, Kupka M, Mansour R. ART utilization: an indicator of access to infertility care // Reprod BioMed Online. 2020. 41:6–9.
65. Zenke U., Chetkowski R.J. Transfer and uterine factors are the major recipient related determinants of success with donor eggs // Fertil Steril. 2004. 82:850–6.
66. Zhang X., Chen C.H., Confino E. Increased endometrial thickness is associated with improved treatment outcome for selected patient undergoing in vitro fertilization: embryo transfer // Fertil Steril. 2005. 83:336–40.
Number of Views: 88
Category of articles:
Reviews
Bibliography link
Zabrodina Yu.V., Akhmedyanova G.U., Khamidullina Z.G. The effect of endometrial thickness on the outcome of assisted reproductive technology programs. Review // Nauka i Zdravookhranenie [Science & Healthcare]. 2023, (Vol.25) 1, pp. 223-231. doi 10.34689/SH.2023.25.1.026Related publications:
INTERRELATION OF INTRAABDOMINAL HYPERTENSION AND MARKERS OF GASTROINTESTINAL TRACT INJURY IN PATIENTS WITH MULTIORGAN DYSFUNCTION
DRUG-INDUCED LIVER INJURY AND GENDER DIFFERENCES
QUALITY OF LIFE IN PRIMARY BILIARY CHOLANGITIS AND ITS ASSESSMENT
DIAGNOSTIC AND THERAPEUTIC LAPAROSCOPY FOR ABDOMINAL INJURIES. REVIEW
METHODS FOR SCHOOL-AGE CHILDREN NUTRITIONAL STATUS ASSESSMENT: FOCUS ON ANTHROPOMETRIC PARAMETERS. A REVIEW.