Fertil Steril. 2008 Apr;89(4):832-9.
The relationship between endometrial thickness
and outcome of medicated frozen embryo
replacement cycles.
El-Toukhy T, Coomarasamy A, Khairy M, Sunkara K,
Seed P, Khalaf Y, Braude P.
Assisted Conception Unit, Guy's and St. Thomas'
Hospital NHS Trust, London, United Kingdom.
tarekeltoukhy@hotmail.com
Objectives:
To examine the relationship between
endometrial thickness and outcome of medicated
frozen-thawed embryo replacement (FER) cycles.
Design:
A retrospective observational study.
Setting:
Assisted conception unit at a
university hospital. PATIENT(S): All patients
who underwent an FER cycle between 1997 and
April 2006 and met the inclusion criteria.
INTERVENTION(S): For endometrial preparation, a
daily dose of 6 mg of oral E(2) valerate was
started on menstrual day 1, and P pessaries (800
mg daily) were administrated when the
endometrial thickness had reached 7 mm or more,
with ET taking place 2-3 days later. The FER
cycles were categorized according to endometrial
thickness measurement on the day of P
supplementation. MAIN OUTCOME MEASURE(S):
Implantation, clinical pregnancy, ongoing
pregnancy, and live birth rates. RESULT(S): In
all, 768 consecutive medicated FER cycles were
analyzed. The lowest pregnancy rates were
associated with endometrial thickness <7 mm (n =
13) and >14 mm (n = 12; 7% in both groups).
Significantly higher implantation (19% vs. 12%),
clinical pregnancy (30% vs. 18%), ongoing
pregnancy (27% vs. 16%), and live birth (25% vs.
14%) rates were achieved in cycles where
endometrial thickness was 9-14 mm (n = 386),
compared with those in which endometrial
thickness was 7-8 mm (n = 357). These
differences remained significant after adjusting
for confounding variables (adjusted odds ratio
[OR] = 1.83 [confidence interval {CI} = 1.3-2.6]
for clinical pregnancy, 1.8 [CI = 1.2-2.6] for
ongoing pregnancy and 1.9 [CI = 1.3-2.8] for
live birth). CONCLUSION(S): In medicated FER
cycles, an endometrial thickness of 9-14 mm
measured on the day of P supplementation is
associated with higher implantation and
pregnancy rates compared with an endometrial
thickness of 7-8 mm.
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