The Study Of Relationship Between Endometrial Thickness And Pregnancy In ART

With the rapid development of ART techchology in the medicaldomain of reproduction,we have gained consensus in the opinion thatfavourable endometrial recepitivity and high-quality embry is the keypoint of success to pregnancy in ART. As the "soil" where embryimplant and develop in, endometrium play a fairly important role inART.Since more than twenty years from the beginning of ART,therewere lots of studies with regard to the relationship of endometrium andpregnancy,but the conclusions obtained were controversial.The object of the study:The primary aim of the present study is to evaluate the impact ofendometrium on PRs. The secondary aim is to assess the factorscontributing to endometrial thickness.And the study could direct clinicalthrapy, especially referred to the endometrial problem whether to cancelcycle or to take uterine cavity examination.The methods of study:1004 cycles are screened out and retrospectively analyzed from thepatients who have experienced IVF/ICSI-ET in the ART Center ofCITIC-XiangYa Reproduction and Genetic Special Hospital fromFebruary 1,2004 to December 31,2006. The patients who are sampleout all achieved ovum pickup (OPU) and transferred good quality embries.According to the subject, we analyze from the six aspects below:1. Comparision of all the parameters including emt betweenpregnant and non-pregant groups.2. The correlation between emt and all the level of hormoneincluding E₂, E₂/egg, P and PRL.3. Constituent ratio of each class range of emt in other parameter'srange, and comparision among the mean of emt in other parameter'sclass range.4. Analysis of the trend of PR(pregnancy rate) accoding to differentclass range of emt and other parameter's correlation with emt.5. Analysis of the trend of PR according to different range of emtbasing on layer of age.6. Multiplicity of all the parameters including emt (endometrialthickness) impacting on pregnancy.Result:1.Age of pregnant group (30.8±3.8 years old ) is younger thannon-pregnant group (31.7±4.3 years old); The emt of pregnant group(11.2±2.7mm) is thicker than non-pregnant group (11.2±2.5mm);Mean comparision of all the parameters excluding P and PRL aresignificantly different between pregnant group and non-pregnant group.2. There exists positive correlation between emt and E₂,but other hormone (P and PRL) doesn't correlate with emt.3.1.The patients of no more than 35 years old have the thickest emt(11.8±2.7mm),whereas, the patients of above 40 years old have thethinnest emt (9.7±1.7mm); The population mean of emt among eachclass range of age (overall three ranges) exists significant difference, andso does the multiple comparision among interclass.3. 2.The emt with range of E₂ no more than 1000pg/ml is thinnerthan range of E₂ from 2000 pg/ml to 4000 pg/ml.The population mean ofemt among each class of E₂ (overall five ranges) exists significantdifference, and so do the multiple comparisions among interclass(onlyfor range 1 and range 3 of E₂, range 1 and range 4 of E₂).3.3.The emt of the least no. of retrieved eggs range is thinner thanthe emt of the other two major ranges as to no. of retrieved eggs byturns.The population mean of emt among each class range of no. ofretrieved eggs (overall three ranges) exists significant differenc, and sodo the multiple comparisions among interclass(only for range 1 andrange 2, range 1 and range 3 of no. of retrieved eggs).3.4.There is no significance as to the emt among interclass of PRL.4. 1.Only for three ranges of E₂ from 1000 pg/ml to 4000pg/ml, thetrend of PR presents higher with the thicker emt.4.2. Only for no.of retrieved eggs ranging from 5 to 13, the trend of PR presents higher with the thicker emt.5. Only for the patients no more than 35 years old, the trend of PRpresents higher with the thicker emt,there is statistically significant(p=0.000).but the patients above 35 years old present not so.6. Stepwise logistic regression for many factors influencingpregnancy.Finally, We obtain the result that age, emt, E₂, no.of retrievedeggs and quality of embry-transferred influence pregnanc.Conclusion:1. The emt presents more thinner as the patient's age increases.weagree the opinion for "aging" of the endometrium,and 35 years old isthe cutoff-point corresponding to physical age of human being; Thereexists positive correlation between emt and E2 on the day of injectedhCG.The obvious low level of E₂ plays disadvantage role for thedevelopment of endomentrium.2. The pregnant group shows younger, thinner emt and more eggsof retrieved than non-pregnant group.3. PR declines obviously with the thinner emt;The thickerendometrium is correlated with a higher PR only for patients who are nomore than 35 years of age.