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Endometrial fluid aspiration immediately prior to embryo transfer does not affect IVF/FET— a prospective matched cohort study

  • Zhaojuan Hou
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
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  • Aihua He
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
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  • Qiong Zhang
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
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  • Nenghui Liu
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
  • Donge Liu
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
  • Yumei Li
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
  • Bin Xu
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
  • Yonggang Wang
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
  • Shuyi Li
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
  • Fen Tian
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
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  • Tingting Liao
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
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  • Yeqing Zhang
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
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  • Jianyun Cao
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
  • Exiang Cao
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
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  • Yanping Li
    Correspondence
    Correspondence address: Department of Reproductive Medicine, Xiangya Hospital, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China, 410008.
    Affiliations
    Department of Reproductive Medicine, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008

    Clinical Research Center For Women's Reproductive Health In Hunan Province, 87 Xiangya Road, Changsha City, Hunan Province, P.R. China 410008
    Search for articles by this author
Published:November 11, 2021DOI:https://doi.org/10.1016/j.rbmo.2021.11.004

      Abstract

      Research question

      Does the endometrial aspiration (EA) of ultrasound-invisible fluid immediately preceding embryo transfer affect in vitro fertilization/frozen-thawed embryo transfer (IVF/FET) outcomes?

      Design

      A prospective matched cohort study was conducted in 96 women and 96 controls to assess the effect of endometrial aspiration performed immediately before embryo transfer on pregnancy outcomes. This study was carried out at a university-affiliated assisted reproductive medical center between January 2019 and December 2019. Patients were divided into two groups: EA group: cycles with EA of ultrasound-invisible fluid performed before embryo transfer and non-EA group featuring cycles without endometrial aspiration. The EA group was matched by propensity score (PS) with the non-EA group at a ratio of 1:1. The EA group consisted of 99 participants before PS matching and 96 participants after matching. The numbers of subjects in the non-EA group before and after PS matching were 203 and 96, respectively.

      Results

      No significant differences were detected in the baseline characteristics and cycle characteristics of the EA and non-EA groups. No significant between-group differences were found in reproductive outcomes in the overall population. Subgroup analysis of blastocyst transfer cycles showed the implantation rate was significantly higher in the EA group (61 women per group; 57.1% vs 40.8%; RR: 1.40; 95%CI: 1.04, 1.88; P=0.022). Live birth rate, clinical pregnancy rate, ongoing pregnancy rate, and multiple pregnancy rate were not different among the groups (P>0.05).

      Conclusion

      The endometrial aspiration immediately preceding embryo transfer does not affect IVF/FET outcomes. Interestingly, it could improve the frozen-thawed blastocyst implantation rate. Randomized controlled trials are needed to confirm this result.

      Study funding

      This study was funded by the National Key Research and Developmental Program of China (grant number 2018YFC1004800) and the National Natural Science Foundation of China (grant number 8187061497).

      Key Words

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      Biography

      LYP, MD, professor and doctoral supervisor of Central South University, Changsha, China and the Director of Reproductive Medicine Center, Xiangya Hospital. She conducts clinical work on infertility, IVF, PGD, intrauterine insemination and microsurgery, and research on reproductive endocrinology, poor ovarian response, thin endometrium and embryonic stem cells.
      Key Message
      The endometrial aspiration of ultrasound-invisible fluid immediately preceding embryo transfer does not affect IVF/FET outcomes. However, patients undergoing blastocyst transfer in the EA group had a significantly higher implantation rate, indicating that it is safe to evaluate endometrial receptivity through endometrial aspiration.