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Association between endometrial thickness and birth weight in fresh IVF/ICSI embryo transfers: a retrospective cohort study of 9273 singleton births

  • Author Footnotes
    # Contributed equally.
    Xiaojie Liu
    Footnotes
    # Contributed equally.
    Affiliations
    Cheeloo College of Medicine, Shandong University, Jinan, China

    Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, No.157 Jingliu Road, Jinan 250000, China
    Search for articles by this author
  • Author Footnotes
    # Contributed equally.
    Han Wu
    Footnotes
    # Contributed equally.
    Affiliations
    Cheeloo College of Medicine, Shandong University, Jinan, China

    Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
    Search for articles by this author
  • Xiao Fu
    Affiliations
    Cheeloo College of Medicine, Shandong University, Jinan, China

    Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, No.157 Jingliu Road, Jinan 250000, China
    Search for articles by this author
  • Jing Li
    Affiliations
    Cheeloo College of Medicine, Shandong University, Jinan, China

    Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, No.157 Jingliu Road, Jinan 250000, China
    Search for articles by this author
  • Meng Zhang
    Affiliations
    Cheeloo College of Medicine, Shandong University, Jinan, China

    Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, No.157 Jingliu Road, Jinan 250000, China
    Search for articles by this author
  • Junhao Yan
    Affiliations
    Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, No.157 Jingliu Road, Jinan 250000, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetic, Jinan, China
    Search for articles by this author
  • Jinlong Ma
    Affiliations
    Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, No.157 Jingliu Road, Jinan 250000, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetic, Jinan, China
    Search for articles by this author
  • Shanshan Gao
    Correspondence
    Corresponding author.
    Affiliations
    Center for Reproductive Medicine, Reproductive Hospital Affiliated to Shandong University, No.157 Jingliu Road, Jinan 250000, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetic, Jinan, China
    Search for articles by this author
  • Author Footnotes
    # Contributed equally.
Published:August 30, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.08.021

      Abstract

      Research question

      What is the association between endometrial thickness (EMT) on HCG trigger day and outcomes related to birth weight in fresh IVF and intracytoplasmic sperm injection (ICSI) embryo transfer cycles?

      Design

      A retrospective cohort study of 9273 singleton live births born to women undergoing fresh IVF/ICSI cycles in a single centre between January 2014 and December 2018. Multivariable logistic regression was used to investigate the associations between EMT, low birth weight (LBW) and small for gestational age (SGA). Multivariable-adjusted linear regression models incorporating restricted cubic splines were used to investigate the dose-response relationship between EMT, birth weight and birth weight z-score, respectively. An EMT of 8 mm was set as a reference value.

      Results

      Compared with women with an EMT of 8.0 to < 14.0 mm the risk of delivering a SGA infant was increased with EMT < 8.0 mm (adjusted odds ratio [aOR] 1.78, 95% confidence interval [CI] 1.09 to 2.90) and decreased with EMT ≥ 14.0 mm (aOR 0.57, 95% CI 0.35 to 0.93, respectively). Birth weights of infants born to women with an EMT of 8.0 mm compared with women with EMT of 5.0, 6.0, and 7.0 mm were lower by 120 g (95% CI –175 g to –66 g), 80 g (95% CI –116 g to –44 g), and 40 g (95% CI –58 g to –22 g) respectively; infant birth weight z-scores were also decreased by 0.19 (95% CI –0.27 to –0.10), 0.12 (95% CI –0.18 to –0.07) and 0.06 (95% CI –0.09 to –0.03), respectively.

      Conclusions

      A thinner endometrium was associated with lower birth weight and birth weight z-score, and higher risk of SGA. Women with a thin endometrium warrant special attention during pregnancy.

      KEYWORDS

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      Biography

      Xiaojie Liu is a postgraduate majoring in obstetrics and gynaecology at the National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University. She is currently studying under Professor Jinlong Ma, who specializes in clinical and basic research into reproductive medicine and pathology.
      Key message
      In IVF and intracytoplasmic sperm injection pregnancies with fresh embryo transfer, a thin endometrium on the day of HCG trigger was associated with lower birth weight and birth weight z-score, and higher risk of small for gestational age neonates. Therefore, women with a thin endometrium warrant special attention during pregnancy.