The predictive value of endometrial thickness in 3117 fresh IVF/ICSI cycles for ectopic pregnancy - 25/01/21

Doi : 10.1016/j.jogoh.2021.102072

Tingfeng Fang ^a,^{^{1
The first 2 authors contributed equally to this article.}}, Manqi Chen ^a,^{^{1
The first 2 authors contributed equally to this article.}}, Wenchang Yu ^a, Tingting Ma ^a, Zheng Su ^b, David Yiu Leung Chan ^c, Mingpeng Zhao ^c, Qiaolan Zheng ^d, Wenjun Wang ^a,⁎
^a Department of Obstetrics & Gynecology, Sun Yat-Sen Memorial Hospital, SunYat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou, 510120, PR China
^b Department of Plastic Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, No. 107 Yanjiang Xi Road, Guangzhou, 510120, PR China
^c Assisted Reproductive Technology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Block E, 1F, Special Block, Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, N.T., Hong Kong
^d Journal Center of the Third Affiliated Hospital of Sun Yat-Sen University, 600 Tianhe Rd, Guangzhou, 510630, PR China

^⁎Corresponding author.

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Abstract

Objectives

To evaluate the predictive value of endometrial thickness (EMT) during in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) cycles for ectopic pregnancy (EP).

Methods

A total of 3068 patients with 3117 fresh IVF/ICSI cycles between January 2016 and February 2019 from the Reproductive Medicine Center of Sun Yat-Sen Memorial Hospital were included in this retrospective study. The patients were divided into an EP group (n = 92) and an intrauterine pregnancy (IUP) group (n = 3025). Multiple logistic regression analysis was conducted to evaluate the EP risk factors. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of the risk factors for EP and calculate the cutoff value of EMT for EP prediction.

Results

The incidence rate of EP was 2.95% (92/3117). After adjustment for other factors in the logistic regression model, the incidence of EP decreased by 55% with an EMT > 10 mm compared with an EMT ≤ 10 mm (odds ratio 0.450, 95% confidence interval 0.296-0.684, P < 0.001). The EMT in the EP group was significantly thinner than that in the live birth (n = 2540) and spontaneous abortion (n = 485) groups (p < 0.017). The cutoff value of EMT for EP prediction was 10.65 mm, with a sensitivity of 59% and a specificity of 63%.

Conclusion

A decreased risk of EP was found among the patients with an EMT > 10 mm prior to embryo transfer. A certain EMT is needed to reduce the incidence of EP.

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Keywords : Ectopic pregnancy, Endometrial thickness, ICSI, IVF