Advertisement

A decrease in endometrial thickness before embryo transfer is not associated with preterm birth and placenta-mediated pregnancy complications

Published:November 23, 2022DOI:https://doi.org/10.1016/j.rbmo.2022.11.010

      Abstract

      Research question

      Does a decrease in endometrial thickness (compaction ≥10%) before embryo transfer prognosticate the risk for preterm birth and placenta-mediated pregnancy complications among IVF pregnancies?

      Design

      Retrospective cohort study at a large private fertility practice. Patients with a singleton live birth after a fresh or frozen embryo transfer between 2016 and 2019 were included. The primary outcome was preterm birth (delivery before 37 weeks gestational age). Secondary outcomes included gestational hypertension, pre-eclampsia, intrauterine growth restriction and placental abruption.

      Results

      Of the 252 patients that met the study criteria, 122 (48%) demonstrated endometrial compaction (≥10%) and 130 (52%) did not. Age, body mass index (BMI), parity, history of preterm birth or history of pre-existing maternal conditions between the compaction and no-compaction groups were not significantly different. The overall prevalence of placenta-mediated complications across all participants was 25% (n = 62). The number of preterm births between the compaction and no-compaction groups (13% and 6%, respectively, P = 0.09) as well as the prevalence of placenta-mediated complications (29.5% and 20%, respectively, P = 0.08) were not significantly different. Findings for the primary outcome (preterm birth) persisted even after adjustment for potential confounding variables, including maternal age, parity, BMI, embryo score and type of embryo transfer (fresh versus frozen) (adjusted OR 1.86, 95% CI 0.64 to 5.38).

      Conclusions

      Endometrial compaction (or decrease in endometrial thickness) before embryo transfer is not associated with preterm birth or placenta-mediated pregnancy complications.

      KEYWORDS

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Reproductive BioMedicine Online
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Armengaud J.B.
        • Yzydorczyk C.
        • Siddeek B.
        • Peyter A.C.
        • Simeoni U.
        Intrauterine growth restriction: Clinical consequences on health and disease at adulthood.
        Reprod. Toxicol. 2021; 99: 168-176
        • Burton G.J.
        • Jauniaux E.
        Pathophysiology of placental-derived fetal growth restriction.
        Am. J. Obstet. Gynecol. 2018; 218: S745-SS61
        • Butwick A.J.
        • Druzin M.L.
        • Shaw G.M.
        • Guo N.
        Evaluation of US State-Level Variation in Hypertensive Disorders of Pregnancy.
        JAMA Netw. Open. 2020; 3e2018741
        • Cochrane E.
        • Pando C.
        • Kirschen G.W
        • Soucier D.
        • Fuchs A.
        • Garry D.J.
        Assisted reproductive technologies (ART) and placental abnormalities.
        J. Perinat. Med. 2020; 48: 825-828
        • Fuchs F.
        • Monet B.
        • Ducruet T.
        • Chaillet N.
        • Audibert F.
        Effect of maternal age on the risk of preterm birth: A large cohort study.
        PLoS ONE. 2018; 13e0191002
        • Gestational Hypertension and Preeclampsia: ACOG Practice Bulletin
        Obstet. Gynecol. 2020; 135 (Number 222): e237-ee60
        • Gui J.
        • Ling Z.
        • Hou X.
        • Fan Y.
        • Xie K.
        • Shen R.
        In vitro fertilization is associated with the onset and progression of preeclampsia.
        Placenta. 2020; 89: 50-57
        • Gyamfi-Bannerman C.
        Society for Maternal-Fetal Medicine (SMFM) Consult Series #44: Management of bleeding in the late preterm period.
        American journal of obstetrics and gynecology. 2018; 218: B2-B8
        • Haas J.
        • Smith R.
        • Zilberberg E.
        • Nayot D.
        • Meriano J.
        • Barzilay E.
        • Casper R.F.
        Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers.
        Fertil. Steril. 2019; 112: 503-509
        • Kramer M.S.
        • Platt R.W.
        • Wen S.W.
        • Joseph K.S.
        • Allen A.
        • Abrahamowicz M.
        • Breart G.
        Fetal/Infant Health Study Group of the Canadian Perinatal Surveillance System. A new and improved population-based Canadian reference for birth weight for gestational age.
        Pediatrics. 2001; 108: E35
        • Koullali B.
        • van Zijl M.D.
        • Kazemier B.M.
        • Oudijk M.A.
        • Mol B.W.J.
        • Pajkrt E.
        • Ravelli A.C.J.
        The association between parity and spontaneous preterm birth: a population-based study.
        BMC Pregnancy Childbirth. 2020; 20: 233
        • Kuriya A.
        • Piedimonte S.
        • Spence A.R.
        • Czuzoj-Shulman N.
        • Kezouh A.
        • Abenhaim H.A.
        Incidence and causes of maternal mortality in the USA.
        J. Obstet. Gynaecol. Res. 2016; 42: 661-668
        • Lam M.T.
        • Li H.W.R
        • Ng E.H.Y.
        Impact of Endometrial Thickness and Volume Compaction on the Live Birth Rate Following Fresh Embryo Transfer of In Vitro Fertilization.
        J. Ultrasound Med. 2021;
        • Liu X.
        • Wang J.
        • Fu X.
        • Li J.
        • Zhang M.
        • Yan J.
        • Gao S.
        • Ma J.
        Thin endometrium is associated with the risk of hypertensive disorders of pregnancy in fresh IVF/ICSI embryo transfer cycles: a retrospective cohort study of 9,266 singleton births.
        Reprod. Biol. Endocrinol. 2021; 19: 55
        • Martel R.A.
        • Blakemore J.K.
        • Grifo J.A.
        The effect of endometrial thickness on live birth outcomes in women undergoing hormone-replaced frozen embryo transfer.
        F S Rep. 2021; 2: 150-155
        • Modest A.M.
        • Johnson K.M.
        • Karumanchi S.A.
        • Resetkova N.
        • Young B.C.
        • Fox M.P.
        • Wise L.A.
        • Hacker M.R.
        Risk of ischemic placental disease is increased following in vitro fertilization with oocyte donation: a retrospective cohort study.
        J. Assist. Reprod. Genet. 2019; 36: 1917-1926
        • Palomba S.
        • de Wilde M.A.
        • Falbo A.
        • Koster M.P.
        • La Sala G.B.
        • Fauser B.C.
        Pregnancy complications in women with polycystic ovary syndrome.
        Hum. Reprod. Update. 2015; : 575-592
        • Palomba S.
        • Piltonen T.T.
        • Giudice L.C.
        Endometrial function in women with polycystic ovary syndrome: a comprehensive review.
        Human Reproduction Update. 2021; 27: 584-618
        • Purisch S.E.
        • Gyamfi-Bannerman C.
        Epidemiology of preterm birth.
        Semin Perinatol. 2017; 41: 387-391
        • Riestenberg C.
        • Quinn M.
        • Akopians A.
        • Danzer H.
        • Surrey M.
        • Ghadir S.
        • Kroener L.
        Endometrial compaction does not predict live birth rate in single euploid frozen embryo transfer cycles.
        J. Assist. Reprod. Genet. 2021; 38: 407-412
        • Rombauts L.
        • Motteram C.
        • Berkowitz E.
        • Fernando S.
        Risk of placenta praevia is linked to endometrial thickness in a retrospective cohort study of 4537 singleton assisted reproduction technology births.
        Hum. Reprod. 2014; 29: 2787-2793
        • Roque M.
        • Haahr T.
        • Geber S.
        • Esteves S.C.
        • Humaidan P.
        Fresh versus elective frozen embryo transfer in IVF/ICSI cycles: a systematic review and meta-analysis of reproductive outcomes.
        Hum. Reprod. Update. 2019; 25: 2-14
        • Shin D.
        • Song W.O.
        Prepregnancy body mass index is an independent risk factor for gestational hypertension, gestational diabetes, preterm labor, and small- and large-for-gestational-age infants.
        J. Matern. Fetal. Neonatal. Med. 2015; 28: 1679-1686
        • Stern J.E.
        • Liu C.L.
        • Hwang S.S.
        • Dukhovny D.
        • Farland L.V.
        • Diop H
        • Coddington C.C.
        • Cabral H.
        Influence of Placental Abnormalities and Pregnancy-Induced Hypertension in Prematurity Associated with Various Assisted Reproductive Technology Techniques.
        J. Clin. Med. 2021; 10
        • Talaulikar V.S.
        • Arulkumaran S.
        Reproductive outcomes after assisted conception.
        Obstet. Gynecol. Surv. 2012; 67: 566-583
        • Zilberberg E.
        • Smith R.
        • Nayot D.
        • Haas J.
        • Meriano J.
        • Barzilay E.
        • Casper R.F.
        Endometrial compaction before frozen euploid embryo transfer improves ongoing pregnancy rates.
        Fertil. Steril. 2020; 113: 990-995

      Biography

      Pavan Gill is a fellow in reproductive endocrinology and infertility at RMA New Jersey. She completed her medical degree and residency in obstetrics and gynaecology at the University of Toronto. Her research interests translational and clinical research on improving ART outcomes, including obstetrical and neonatal outcomes in ART pregnancies.
      Key message
      IVF has been associated with an increased risk of placenta-mediated pregnancy complications. Endometrial thickness before embryo transfer has been identified as a potential risk factor. A decrease in endometrial thickness (compaction) during the window of implantation is not associated with a higher risk of placenta-mediated pregnancy complications.