Background： Thin endometrium is associated with poor reproductive outcomes; estrogen treatment can increase endomctrial thickness （EMT）. The aim of this retrospective cohort study was to investigate the factors inf...Background： Thin endometrium is associated with poor reproductive outcomes; estrogen treatment can increase endomctrial thickness （EMT）. The aim of this retrospective cohort study was to investigate the factors influencing the effectiveness of estrogen treatment and reproductive outcomes after the treatment in patients with thin endometrium. Methods： Relevant clinical data of 101 patients with thin endometrium who had undergone estrogen treatment were collected. Possible factors influencing the effectiveness of treatment were analyzed retrospectively by logistic regression analysis. Eighty-seven infertile women without thin endometrium who had undergone assisted reproduction served as controls. The cases and controls were matched for age, assisted reproduction method, and number of embryos transferred. Reproductive outcomes of study and control groups were compared using Student＇s t-test and the Chi-square test. Results： At the end of estrogen treatment, EMT was ≥8 mm in 93/101 patients （92.1%）. Effectiveness of treatment was significantly associated with maximal pretreatment EMT （P = 0.017） and treatment duration （P = 0.004）. The outcomes of assisted reproduction were similar in patients whose treatment was successful in increasing EMT to ≥8 mm and the control group. The rate of clinical pregnancy in patients was associated with the number of good-quality embryos transferred in both fresh （P = 0.005） and frozen-thawed （P = 0.000） embryo transfer cycles. Conclusions： Thinner EMT before estrogen treatment requires longer treatment duration and predicts poorer treatment outcomes. The effectiveness of treatment depends on the duration of estrogen administration. Assisted reproductive outcomes of patients whose treatment is successful （i.e., achieves an EMT ≥8 mm） are similar to those of controls. The quality of embryos transferred is an important predictor of assisted reproductive outcomes in patients treated successfully with exogenous estrogen.展开更多
Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT a...Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT and EP and explore the cutoff value of EMT to predict EP.Methods:This retrospective cohort study included women aged 20-45 years undergoing FET between March 2015 and September 2021.The primary outcomes and measured variables were EP and EMT,respectively.The threshold effect of EMT on EP was calculated based on a constructed smooth curve fitting.The patients were divided into two groups based on the threshold for comparison.A subgroup analysis was conducted to examine whether the relationship between EMT and EP remained consistent across the different subgroups.Additionally,a generalized linear model was used to analyze the interactions between the treatment factors and EMT in EP.Results:In total,27,549 FET cycles were included,with 27,086 intrauterine and 463 ectopic pregnancies.The risk of EP in the EMT≤8.7 mm group was 3.36 times higher than that in the EMT>8.7 mm group(odds ratio[OR]:3.36,95%confidence interval[CI]:2.57-4.05).Subgroup analysis further indicated that a thin EMT was a risk factor for EP,independent of other risks.We also noted that diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may further enhance the risk of EP in patients with thin endometrium.Conclusions:Thin endometrium was associated with an increased risk of EP.Patients with EMT less than 8.7 mm need close medical observation and management after embryo transfer.In addition,diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may significantly enhance the effect of a thin endometrium on the risk of EP.展开更多
目的分析经腹彩超检查子宫内膜厚度在绝经前妇女子宫内膜疾病中的诊断价值。方法回顾性分析60例绝经前妇女的临床资料,均接受经腹彩超检查和病理检查,比较不同年龄患者的子宫内膜厚度,不同病理类型患者的子宫内膜均匀程度,不同子宫内膜...目的分析经腹彩超检查子宫内膜厚度在绝经前妇女子宫内膜疾病中的诊断价值。方法回顾性分析60例绝经前妇女的临床资料,均接受经腹彩超检查和病理检查,比较不同年龄患者的子宫内膜厚度,不同病理类型患者的子宫内膜均匀程度,不同子宫内膜厚度患者的生理、病理结果。结果60例患者中,病理检查正常子宫内膜14例(23.33%),子宫内膜炎13例(21.67%),子宫内膜增生21例(35.00%),子宫内膜不典型增生6例(10.00%),子宫内膜癌6例(10.00%)。年龄<40岁、年龄≥40岁患者的子宫内膜厚度分别为(6.38±1.44)mm、(6.44±1.88)mm,平均子宫内膜厚度为(6.42±1.86)mm。不同年龄患者的子宫内膜炎、正常子宫内膜、子宫内膜增生、子宫内膜不典型增生、子宫内膜癌患者的子宫内膜厚度逐渐增加。60例患者中,子宫内膜均匀37例(61.67%),不均匀23例(38.33%)。其中子宫内膜炎、正常子宫内膜、子宫内膜增生、子宫内膜不典型增生、子宫内膜癌患者的年龄逐渐增长,子宫内膜均匀率逐渐升高。60例患者中,子宫内膜厚度<10 mm 15例(25.00%),≥10 mm 45例(75.00%)。其中子宫内膜厚度<10 mm患者的增殖期占比高于子宫内膜厚度≥10 mm患者,差异有统计学意义(P<0.05)。子宫内膜厚度<10 mm患者的子宫内膜增生占比低于子宫内膜厚度≥10 mm患者,差异有统计学意义(P<0.05)。不同子宫内膜厚度患者子宫内膜炎、正常子宫内膜、子宫内膜不典型增生、子宫内膜癌占比比较差异无统计学意义(P>0.05)。结论在绝经前妇女子宫内膜疾病诊断中经腹彩超检查子宫内膜厚度的诊断价值高,值得推广。展开更多
文摘Background： Thin endometrium is associated with poor reproductive outcomes; estrogen treatment can increase endomctrial thickness （EMT）. The aim of this retrospective cohort study was to investigate the factors influencing the effectiveness of estrogen treatment and reproductive outcomes after the treatment in patients with thin endometrium. Methods： Relevant clinical data of 101 patients with thin endometrium who had undergone estrogen treatment were collected. Possible factors influencing the effectiveness of treatment were analyzed retrospectively by logistic regression analysis. Eighty-seven infertile women without thin endometrium who had undergone assisted reproduction served as controls. The cases and controls were matched for age, assisted reproduction method, and number of embryos transferred. Reproductive outcomes of study and control groups were compared using Student＇s t-test and the Chi-square test. Results： At the end of estrogen treatment, EMT was ≥8 mm in 93/101 patients （92.1%）. Effectiveness of treatment was significantly associated with maximal pretreatment EMT （P = 0.017） and treatment duration （P = 0.004）. The outcomes of assisted reproduction were similar in patients whose treatment was successful in increasing EMT to ≥8 mm and the control group. The rate of clinical pregnancy in patients was associated with the number of good-quality embryos transferred in both fresh （P = 0.005） and frozen-thawed （P = 0.000） embryo transfer cycles. Conclusions： Thinner EMT before estrogen treatment requires longer treatment duration and predicts poorer treatment outcomes. The effectiveness of treatment depends on the duration of estrogen administration. Assisted reproductive outcomes of patients whose treatment is successful （i.e., achieves an EMT ≥8 mm） are similar to those of controls. The quality of embryos transferred is an important predictor of assisted reproductive outcomes in patients treated successfully with exogenous estrogen.
基金National Natural Science Foundation of China(grant no.81971391)。
文摘Objective:Few studies have explored the suitability of endometrial thickness(EMT)as a predictor of ectopic pregnancy(EP)in frozen embryo transfer(FET)cycles.Our study aimed to investigate the association between EMT and EP and explore the cutoff value of EMT to predict EP.Methods:This retrospective cohort study included women aged 20-45 years undergoing FET between March 2015 and September 2021.The primary outcomes and measured variables were EP and EMT,respectively.The threshold effect of EMT on EP was calculated based on a constructed smooth curve fitting.The patients were divided into two groups based on the threshold for comparison.A subgroup analysis was conducted to examine whether the relationship between EMT and EP remained consistent across the different subgroups.Additionally,a generalized linear model was used to analyze the interactions between the treatment factors and EMT in EP.Results:In total,27,549 FET cycles were included,with 27,086 intrauterine and 463 ectopic pregnancies.The risk of EP in the EMT≤8.7 mm group was 3.36 times higher than that in the EMT>8.7 mm group(odds ratio[OR]:3.36,95%confidence interval[CI]:2.57-4.05).Subgroup analysis further indicated that a thin EMT was a risk factor for EP,independent of other risks.We also noted that diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may further enhance the risk of EP in patients with thin endometrium.Conclusions:Thin endometrium was associated with an increased risk of EP.Patients with EMT less than 8.7 mm need close medical observation and management after embryo transfer.In addition,diminished ovarian reserve,tubal factor infertility,transfer of two embryos,or transfer of cleavage-stage embryos may significantly enhance the effect of a thin endometrium on the risk of EP.
文摘目的分析经腹彩超检查子宫内膜厚度在绝经前妇女子宫内膜疾病中的诊断价值。方法回顾性分析60例绝经前妇女的临床资料,均接受经腹彩超检查和病理检查,比较不同年龄患者的子宫内膜厚度,不同病理类型患者的子宫内膜均匀程度,不同子宫内膜厚度患者的生理、病理结果。结果60例患者中,病理检查正常子宫内膜14例(23.33%),子宫内膜炎13例(21.67%),子宫内膜增生21例(35.00%),子宫内膜不典型增生6例(10.00%),子宫内膜癌6例(10.00%)。年龄<40岁、年龄≥40岁患者的子宫内膜厚度分别为(6.38±1.44)mm、(6.44±1.88)mm,平均子宫内膜厚度为(6.42±1.86)mm。不同年龄患者的子宫内膜炎、正常子宫内膜、子宫内膜增生、子宫内膜不典型增生、子宫内膜癌患者的子宫内膜厚度逐渐增加。60例患者中,子宫内膜均匀37例(61.67%),不均匀23例(38.33%)。其中子宫内膜炎、正常子宫内膜、子宫内膜增生、子宫内膜不典型增生、子宫内膜癌患者的年龄逐渐增长,子宫内膜均匀率逐渐升高。60例患者中,子宫内膜厚度<10 mm 15例(25.00%),≥10 mm 45例(75.00%)。其中子宫内膜厚度<10 mm患者的增殖期占比高于子宫内膜厚度≥10 mm患者,差异有统计学意义(P<0.05)。子宫内膜厚度<10 mm患者的子宫内膜增生占比低于子宫内膜厚度≥10 mm患者,差异有统计学意义(P<0.05)。不同子宫内膜厚度患者子宫内膜炎、正常子宫内膜、子宫内膜不典型增生、子宫内膜癌占比比较差异无统计学意义(P>0.05)。结论在绝经前妇女子宫内膜疾病诊断中经腹彩超检查子宫内膜厚度的诊断价值高,值得推广。
