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Nomogram to predict an endometrial thickness above 7.5 mm in the frozen embryo transfer cycle of women with a thin endometrium

  • Zizhen Guo
    Affiliations
    School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250001, China

    Reproductive Hospital Affiliated to Shandong University, Jinan Shandong 250001, China

    Centre for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250012, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan Shandong 250012, China
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  • Wei Chen
    Affiliations
    Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250012, China
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  • Yuqing Wang
    Affiliations
    School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250001, China

    Reproductive Hospital Affiliated to Shandong University, Jinan Shandong 250001, China

    Centre for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250012, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan Shandong 250012, China
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  • Ran Chu
    Affiliations
    School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250001, China
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  • Xinxin Xu
    Affiliations
    Reproductive Hospital Affiliated to Shandong University, Jinan Shandong 250001, China

    Centre for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250012, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan Shandong 250012, China
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  • Lixia Zhang
    Affiliations
    Maternal and Child Health Hospital in Yanggu County Shandong Province
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  • Lei Yan
    Correspondence
    Corresponding author.
    Affiliations
    School of Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250001, China

    Reproductive Hospital Affiliated to Shandong University, Jinan Shandong 250001, China

    Centre for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250012, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan Shandong 250012, China
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  • Jinlong Ma
    Affiliations
    Reproductive Hospital Affiliated to Shandong University, Jinan Shandong 250001, China

    Centre for Reproductive Medicine, Cheeloo College of Medicine, Shandong University, Jinan Shandong 250012, China

    National Research Centre for Assisted Reproductive Technology and Reproductive Genetics, Shandong University, Jinan Shandong 250012, China
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Published:November 09, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.10.022

      Abstract

      Research question

      Which characteristics of patients with a thin endometrium (endometrial thickness [EMT] ≤7.5 mm on human chorionic gonadotrophin [HCG] trigger day) suggest the possibility of an EMT >7.5 mm in the subsequent frozen cycle?

      Design

      Data were collected from the university-affiliated Centre for Reproductive Medicine between January 2013 and September 2019. Multivariable logistic regression was used to generate the final prediction model and construct the nomogram. Model performances were quantified by discrimination and calibration.

      Results

      The predictive variables that entered the final model were: hysteroscopic adhesiolysis history, polycystic ovary syndrome status, application of clomiphene in the ovarian stimulation process, the ovarian stimulation protocol and the endometrial preparation protocol. The receiver operating characteristic (ROC) curve for the final model and validation cohort was 0.760 (95% confidence interval [CI] 0.722–0.797) and 0.713 (95% CI 0.664–0.759), respectively. Discrimination performed well in both the modelling and validation cohorts.

      Conclusions

      In women with a thin endometrium (EMT ≤7.5 mm on HCG trigger day), the absence of a hysteroscopic adhesiolysis history, the presence of polycystic ovary syndrome, the application of clomiphene in the ovarian stimulation process, the application of a gonadotrophin-releasing hormone agonist short protocol, mild stimulation protocol, natural cycle protocol, and natural cycle for endometrial preparation are prognostic for an increased possibility of an EMT >7.5 mm in the subsequent frozen cycle.

      Keywords

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      Biography

      Guo Zizhen is carrying out a PhD in Reproductive Medicine at School of Medicine, Cheeloo College of Medicine, Shandong University. Her current academic focus is on reproductive medicine and women with thin endometrium.
      Key message
      This study created a well-calibrated model to predict the possibility of EMT >7.5 mm in the subsequent frozen cycle for women with a thin endometrium. This model could help clinicians refer such women either to directly receive fresh embryo transfer or adopt a ‘freeze-all’ strategy for frozen embryo transfer.