ArticleHuman reproduction open2025
Endometrial compaction shows no association with improved pregnancy outcomes in hormonal replacement frozen-thawed embryo transfer: an analysis of over 16 000 cases.
Article in Human reproduction open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
study questionIs there an association between changes in endometrial thickness (EMT) following progesterone administration and pregnancy outcomes in frozen-thawed embryo transfers (FETs) at Day 3 (D3) and blastocyst stages? SUMMARY ANSWER: Endometrial compaction is not associated with better pregnancy outcomes. WHAT IS KNOWN ALREADY: Previous studies have shown conflicting results on the impact of EMT changes on FET outcomes. STUDY DESIGN SIZE DURATION: This study was a single-center retrospective cohort analysis of FETs from 1 January 2018 to 31 December 2022. A total of 9390 D3 FETs and 7063 blastocyst FETs were included during this period. PARTICIPANTS/MATERIALS SETTING
methodsD3 FETs and blastocyst FETs were divided into three groups: compaction group, non-change group, and expansion group. The impact of EMT changes after progesterone administration on HCG-positive, pregnancy, ongoing pregnancy, live birth, and pregnancy loss rates were analyzed for D3 and blastocyst FETs. EMT on the progesterone administration day (defined as EMT1) and on embryo transfer (ET)day (defined as EMT2) was measured exclusively by transvaginal ultrasound. Inverse probability weighting (IPW) and stratified logistic regressions were conducted to reduce the effects of confounding factors. MAIN RESULTS AND THE ROLE OF CHANCE: After IPW adjustment, in D3 FETs, women with compacted endometrium had the lowest HCG-positive rates ( LIMITATIONS REASONS FOR CAUTION: This study only included retrospective analyses of untested embryos for FETs. WIDER IMPLICATIONS OF THE
findingsEndometrial expansion in D3 FETs exhibited a positive association with improved LBRs, but not in blastocyst FETs. These findings suggest that embryo developmental stage-specific endometrial preparation protocols may enhance assisted reproductive outcomes. STUDY FUNDING/COMPETING INTERESTS: This study was supported by National Natural Science Foundation of China (82201856), Basic Scientific Research project of Wenzhou Science and Technology Bureau (Y20220006), Wenzhou Key Laboratory of Reproduction and Genetics (2022HZSY0051), and Clinical Technology International Exchange Project of Zhejiang Provincial Medical Institutions. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: N/A.
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