Does the Pattern of Endometrium Influence the Frozen Embryo Transfer Cycle Outcome?

Abstract

Introduction: Implantation rates vary between 25-35% despite all advancements in Assisted Reproductive Technology (ART). Successful implantation requires embryo endometrial synchrony. Transvaginal Ultrasonography (TVS) plays an essential role in assessing endometrial receptivity. Aim: To study the influence of different echo patterns of the endometrium in predicting the outcome of Frozen Embryo Transfer (FET) cycle. Materials and Methods: A prospective observational study was performed to determine the effect of endometrial pattern on the outcomes of FET cycles. A total of 348 women who underwent endometrial preparation for FET from January 2012 to December 2017 were included. On the day of starting progesterone, the study participants were divided into three groups based on the endometrial pattern: Type A: Triple line or multilayer pattern; Type B: Isoechoic pattern; and Type C: Hyperechoic pattern.The association of endometrial pattern with the outcomes of FET cycles- pregnancy rate (primary end point), clinical pregnancy and live birth rate (secondary outcome), were determined. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 23.0 software using paired student’s t-test, Chi-square test, Fisher’s-exact test, Analysis of Variance (ANOVA) and logistic regression. A probability value of <0.05 was considered statistically significant. Results: The baseline characteristics such as Body Mass Index (BMI), duration, type and causes of infertility, were comparable between the study groups. There was no significant difference in the pregnancy, clinical pregnancy and miscarriage rates, and live birth rates between the study groups (Pregnancy rate: Type A: 55.9%; Type B: 51.2%; and Type C: 44.4%; p=0.594). Conclusion: According to the above findings, the endometrial pattern doesn’t significantly influence the outcomes of FET cycles.

Keywords

• endometrial pattern
• live birth rate
• miscarriage rate
• pregnancy rate
• triple line endometrium
• transvaginal sonography