Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT a...Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT and EP and explore the cutoff value of EMT to predict EP.Methods:This retrospective cohort study included women aged 20-45 years undergoing FET between March 2015 and September 2021.The primary outcomes and measured variables were EP and EMT,respectively.The threshold effect of EMT on EP was calculated based on a constructed smooth curve fitting.The patients were divided into two groups based on the threshold for comparison.A subgroup analysis was conducted to examine whether the relationship between EMT and EP remained consistent across the different subgroups.Additionally,a generalized linear model was used to analyze the interactions between the treatment factors and EMT in EP.Results:In total,27,549 FET cycles were included,with 27,086 intrauterine and 463 ectopic pregnancies.The risk of EP in the EMT≤8.7 mm group was 3.36 times higher than that in the EMT>8.7 mm group(odds ratio[OR]:3.36,95%confidence interval[CI]:2.57-4.05).Subgroup analysis further indicated that a thin EMT was a risk factor for EP,independent of other risks.We also noted that diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may further enhance the risk of EP in patients with thin endometrium.Conclusions:Thin endometrium was associated with an increased risk of EP.Patients with EMT less than 8.7 mm need close medical observation and management after embryo transfer.In addition,diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may significantly enhance the effect of a thin endometrium on the risk of EP.展开更多
Objective:To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer(FET),including natural cycle(NC),hormone replacement therapy cycle(HRT),go...Objective:To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer(FET),including natural cycle(NC),hormone replacement therapy cycle(HRT),gonadotropin-releasing hormone agonist artificial cycle(GAC),and ovarian stimulation cycle(OC).Methods:This retrospective cohort study enrolled 10,333 cycles of frozen embryo transfer performed at Xinan Gynecological Hospital in Sichuan,China,from January 2018 to December 2018.The patient's baseline characteristics and pregnancy outcomes were extracted from the medical record system.Pregnancy outcomes were compared among the four groups and multiple logistic regression models were used to adjust for the confounding factors.Results:After adjusting for covariates,multiple logistic regression analysis showed no statistical significance in pregnancy outcomes in the HRT group,GAC group,and OC group compared to the NC group in the entire population.The adjusted odds ratio of live birth was 0.976(95%)confidence interval[Cl](0.837-1.138)for the HRT group,0.959(95%confidence interval 0.797-1.152)for the GAC group,and 0.909(95%confidence interval 0.763-1.083)for the OC group.Conclusions:The natural protocol had comparable pregnancy outcomes compared to the other three endometrial preparation protocols in the overall FET population.More high-quality prospective randomized controlled trials are required to assess the efficacy of the four protocols and explore the optimal one.展开更多
基金National Natural Science Foundation of China(grant no.81971391)。
文摘Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT and EP and explore the cutoff value of EMT to predict EP.Methods:This retrospective cohort study included women aged 20-45 years undergoing FET between March 2015 and September 2021.The primary outcomes and measured variables were EP and EMT,respectively.The threshold effect of EMT on EP was calculated based on a constructed smooth curve fitting.The patients were divided into two groups based on the threshold for comparison.A subgroup analysis was conducted to examine whether the relationship between EMT and EP remained consistent across the different subgroups.Additionally,a generalized linear model was used to analyze the interactions between the treatment factors and EMT in EP.Results:In total,27,549 FET cycles were included,with 27,086 intrauterine and 463 ectopic pregnancies.The risk of EP in the EMT≤8.7 mm group was 3.36 times higher than that in the EMT>8.7 mm group(odds ratio[OR]:3.36,95%confidence interval[CI]:2.57-4.05).Subgroup analysis further indicated that a thin EMT was a risk factor for EP,independent of other risks.We also noted that diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may further enhance the risk of EP in patients with thin endometrium.Conclusions:Thin endometrium was associated with an increased risk of EP.Patients with EMT less than 8.7 mm need close medical observation and management after embryo transfer.In addition,diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may significantly enhance the effect of a thin endometrium on the risk of EP.
基金supported by the grants from Natural Science Foundation of Chongqing(Nos:cstc2019jcyj-msxmX0749,cstc2019jxjl130030,cstc2018jxjl130065)Intelligent Medicine Research Project of Chongqing Medical University(YJSZHYX202010)Sichuan Provincial Science and Technology Plan Project(2019YFSY0047)and Applied Basic Research Project in Sichuan Province(2018JY0357).
文摘Objective:To evaluate the pregnancy outcomes of the four endometrial preparation protocols for people undergoing frozen-thawed embryo transfer(FET),including natural cycle(NC),hormone replacement therapy cycle(HRT),gonadotropin-releasing hormone agonist artificial cycle(GAC),and ovarian stimulation cycle(OC).Methods:This retrospective cohort study enrolled 10,333 cycles of frozen embryo transfer performed at Xinan Gynecological Hospital in Sichuan,China,from January 2018 to December 2018.The patient's baseline characteristics and pregnancy outcomes were extracted from the medical record system.Pregnancy outcomes were compared among the four groups and multiple logistic regression models were used to adjust for the confounding factors.Results:After adjusting for covariates,multiple logistic regression analysis showed no statistical significance in pregnancy outcomes in the HRT group,GAC group,and OC group compared to the NC group in the entire population.The adjusted odds ratio of live birth was 0.976(95%)confidence interval[Cl](0.837-1.138)for the HRT group,0.959(95%confidence interval 0.797-1.152)for the GAC group,and 0.909(95%confidence interval 0.763-1.083)for the OC group.Conclusions:The natural protocol had comparable pregnancy outcomes compared to the other three endometrial preparation protocols in the overall FET population.More high-quality prospective randomized controlled trials are required to assess the efficacy of the four protocols and explore the optimal one.
