Effect Of Endometrial Cavity Fluid On The Pregnancy Outcomes Of In Vitro Fertilization/intracytoplasmic Sperm Injection

Bacground and objectivesAt present,several studies have suggested a relationship between uterine pathology and decreased fertility and spontaneous abortion.In the process of in vitro fertilization embryo transfer(IVF-ET),the endometrial microenvironment is vital,and successful implantation requires synchronous development of the embryo and endometrium?Endometrial cavity fluid is discovered by ultrasound and indicates an effusion or foreign body in the uterus cavity that separates the two walls.ECF(endometrial cavity fluid)is the most common contributor.This fluid consists of blood,mucus,endometrial secretions,and/or tubal fluid.Endometrial cavity fluid may alter the endometrial microenvironment and affect pregnancy outcome.There is study suggesting that embryonal apposition may not occur when a fluid layer is overlaying the endometrium;the fluid within the endometrial cavity before embryo transfer in IVF cycles is associated with failed implantation.Excessive uterine fluid is detrimental to embryo implantation.Some studies have reported that if the endometrial cavity fluid was generated physiologically by the genital tract—like the ECF demonstrated in patients without hydrosalpinx or bilateral tubal obstruction—the clinical pregnancy was not worse than for patients without ECF,and there was no influence of this kind of ECF on embryo implantation.Perloe M concluded that if the ECF was not flushed backwards from the hydrosalpinx but was generated physiologically by the genital tract during controlled ovarian hyperstimulation(COH),the clinical pregnancy rate was not worse.At present,the effect of endometrial cavity fluid on IVF/intracytoplasmic sperm injection(ICSI)pregnancy outcomes remains incompletely understood and a controversial area.We investigated the effect of endometrial cavity fluid on the pregnancy outcomes of IVF/ICSI to help determine whether to intervene in patients with endometrial cavity fluid when performing COH.A cohort study with a large sample size was conducted to explore the effect of endometrial cavity fluid on IVF pregnancy outcomes.To study the effect of endometrial cavity fluid on the pregnancy outcomes of in vitro fertilization(IVF)/intracytoplasmic sperm injection(ICSI).MethodsWe included 3618 IVF/ICSI cases with endometrial cavity fluid diagnosed by ultrasound in the process of controlled ovarian hyperstimulation(COH),as the study group.According to certain matching criteria,We performed matching from homochronous IVF/ICSI patients according to the following criteria:1)No endometrial cavity fluid;2)Number of IVF/ICSI cycles;3)Age(± 1 year);4)Endometrial thickness of human chorionic gonadotrophin(HCG)days(±0.1 cm);5)Type of infertility(primary or secondary);6)Protocol of COH.By using these criteria,blind 1:1 matching was performed of IVF/ICSI pregnancy outcomes.We collected the medical history of the study group and the control group as well as auxiliary examination results.Pregnancy outcomes were compared between the two groups.ResultsPregnancy outcomes were compared between the two groups.The study group had a significantly lower clinical pregnancy rate(57.32%vs.61,77%,P<0.001),live birth rate(49.36%vs.52.49%,P=0.008),and biochemical pregnancy rate(64.43%vs.68.82%,P<0.001).ConclusionThere is a statistically significant correlation between endometrial cavity fluid and IVF/ICSI pregnancy outcome.Endometrial cavity fluid detected by ultrasound may have a negative effect on IVF/ICSI pregnacy outcome.The clinical pregnancy rate,live birth rate,and biochemical pregnancy rate of the patients with endometrial cavity fluid n were lower than those without endometrial cavity fluid;therefore,maybe it's necessary to treat the endometrial cavity fluid during IVF-ET/ICSI.