ArticleBMC pregnancy and childbirth2026
Definition of thin endometrium from the perspective of miscarriage following frozen embryo transfer: a retrospective cohort study of 15,979 pregnancies.
Article in BMC pregnancy and childbirth, 2026. 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
backgroundThis study aimed to explore whether an endometrial thickness (EMT) cutoff of 7 mm or 8 mm was more appropriate to define thin endometrium (TE) from the perspective of miscarriage and obstetric-neonatal complications.
methodsWe conducted a retrospective cohort study of 15,979 patients who had a positive serum β-human chorionic gonadotropin test after undergoing their first frozen-thaw embryo transfer. The main outcomes were early pregnancy loss, late pregnancy loss, and the rates of obstetric and neonatal complications.
resultsWhen TE was defined by EMT <8 mm, the TE group exhibited a similar risk of early miscarriage (17.2% versus 15.7%, P=0.086) to the control group (EMT ≥8 mm). However, the TE group defined by EMT <7 mm had significantly higher rates of early miscarriage (21.5% versus 15.6%, P<0.001) than the control group (EMT ≥7 mm). The conclusion remained consistent after adjustment for age and other confounders in logistic regression. In addition, the adjusted odds ratio (aOR) for preterm birth increased from 1.281 (95% CI: 1.022-1.606) at an EMT <8 mm to 2.050 (95% CI: 1.427-2.945) at an EMT <7 mm, and the aOR for low birth weight increased from 1.394 (95% CI: 1.041-1.867) at an EMT <8 mm to 2.488 (95% CI: 1.611-3.843) at an EMT <7 mm.
conclusionsWhen thin endometrium was defined as EMT <7 mm, the TE group had significantly higher risks of early miscarriage, preterm birth, and low birth weight than when thin endometrium was defined as EMT <8 mm. Because dilation and curettage after miscarriage may further damage the endometrium in patients with thin endometrium, pregnancy loss should be considered when debating the definition of thin endometrium.
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