Abstract
Research question
Does endometrial thickness (EMT) predict adverse neonatal outcomes in singleton pregnancies
after in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) frozen
embryo transfer (FET)?
Design
This retrospective study involved 13,383 women undergoing IVF/ICSI FET cycles between
January 2010 and December 2018 in Women's Hospital of Zhejiang University. The primary
outcome was preterm delivery (PTD). The secondary outcomes were small for gestational
age (SGA), large for gestational age (LGA) and low birthweight (LBW).
Results
A total of 13,383 FET cycles resulting in 5220 singleton live births and 8163 failed
cycles were included. Multiple spline regression visualization showed an increasing
risk of PTD and LBW for a thin EMT. By comparing multiple cut-off points using area
under the curve, a cut-off point of 8 mm was identified, which was used to categorize
EMT. A reference point of EMT greater than 8 mm was used; after adjusting for covariates,
individuals with EMT less than 8 mm had an adjusted odds ratio of 1.75 (95% CI 1.30
to 2.34) for PTD, 1.57 (95% CI 1.09 to 2.26) for LBW, 0.97 (95% CI 0.63 to 1.50) for
SGA and 1.04 (95% CI 0.79 to 1.37) for LGA. Additional analyses showed similar increasing
risk with a thin endometrium for both PTD with and without caesarean section, and
PTD with low and normal birthweight percentiles.
Conclusion
A clinical cut-off point of 8 mm has been identified, below which risk of PTD and
LBW increases in women undergoing IVF/ICSI.
KEYWORDS
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Biography
Andrew Kawai is a medical student at Monash University and has an interest in applying machine learning and statistical methodology to obstetrics and gynaecology. He is a strong believer in evidence-based practice.
Article info
Publication history
Published online: April 24, 2021
Accepted:
April 11,
2021
Received in revised form:
April 9,
2021
Received:
December 27,
2020
Declaration: The authors report no financial or commercial conflicts of interest.Identification
Copyright
© 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
