Influence of endometrial thickness and embryo placement distance from fundus in in-vitro fertilization treatment

Divya Selvamani; Madhuvanthi Gurumoortthy; Abinaya Anandaraj; M. Elanchezhian

doi:10.18203/2320-1770.ijrcog20221676

Authors

Divya Selvamani Department of IVF and Genetics, Srushti Fertility Centre and Women’s Hospital, Chennai, India
Madhuvanthi Gurumoortthy Asia Pacific Institute of Embryology, University of Mysore, Mysore, India
Abinaya Anandaraj Asia Pacific Institute of Embryology, University of Mysore, Mysore, India
M. Elanchezhian Pearl Singapore Fertility Centre and Research Institute, Chennai, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20221676

Keywords:

Endometrial thickness, Distance from fundus, Embryo transfer, Ultrasound guidance, Clinical pregnancy

Abstract

Background: In-vitro fertilization–embryo transfer (IVF-ET) has become progressively popular as a treatment for different type of infertility issues. Implantation of the embryo is an essential step and depends on various factors that play pivotal role in influencing the pregnancy outcomes in IVF cycle. It directly impacts on the efficiency of embryo transfer procedure, site of embryo deposition, catheter loading technique, embryo placement distance from the fundus and thickness of endometrium.

Methods: In the present retrospective study, data from IVF-ET treatment cycles conducted at Srushti Fertility Centre and Women’s Hospital, Chennai, for a period between October 2021 and February 2022 were analysed. Women were divided into four groups according to embryo placement distance from fundus post embryo transfer group 1: <10 mm, group 2: >10 to <15 mm, group 3: >15 to <20 mm and group 4: >20 mm. According to endometrial thickness they were divided into two groups, group A: 6-10 mm and group B: 10-14 mm. Clinical pregnancy were assessed between the groups.

Results: Clinical pregnancy rates were higher in groups 2 and 3 when compared to embryo placement distance from fundus 62.3% and 82.2%, distance of 10 mm and 20 mm and endometrial thickness of more than 10 mm (group B) had higher clinical pregnancy rates 66.3% than (group A) 43.5%.

Conclusion: Ideal ET depth and optimum endometrial thickness were found to influence the clinical pregnancy rates. Embryo placement at 10-20 mm from fundus and endometrial thickness of more than 10 mm is recommended for optimal clinical pregnancy outcomes.

Metrics

Metrics Loading ...

References

Bayram A, Munck N, Elkhatib I, Arnanz A, El-damen A, Abdala A, et al. The position of the euploid blastocyst in the uterine cavity influences implantation. Reproductive BioMedicine Online. 2021;43(5):880-9.

Wang Y, Zhu Y, Sun Y, Di W, Qiu M, Kuang Y, et al. Ideal embryo transfer position and endometrial thickness in IVF embryo transfer treatment. Int J Gynecol Obstet. 2018;143(3):282-8.

Ernesto B, Simone B, George G, Michael G, Peter H, Estratios K , et al. The ESHRE Guideline Group on Ovarian Stimulation. ESHRE guideline: ovarian stimulation for IVF/ICSI†. Human Reproduction Open. 2020;2:hoaa009.

Depalo R, Jayakrishan K, Garruti G, Totaro I, Panzarino M, Giorgino F, et al. GnRH agonist versus GnRH antagonist in in vitro fertilization and embryo transfer (IVF/ET). Reprod Biol Endocrinol. 2012;10:26.

Kovacs P, Matyas S, Boda K, Kaali SG. The effect of endometrial thickness on IVF/ICSI outcome. Reprod Biol Endocrinol. 2003;18(11):2337-41.

Guo Z, Chen W, Wang Y, Chu R, Xu X, Zhang L, et al. Nomogram to predict an endometrial thickness above 7.5 mm in the frozen embryo transfer cycle of women with a thin endometrium. Reproductive BioMedicine Online. 2021;44(2):324-32.

Kalem Z, Kalem MN, Gürgan T. Methods for endometrial preparation in frozen-thawed embryo transfer cycles. J Turkish German Gynecol Assoc. 2016;17(3):168-72.

Mensing L, Dahlberg ES, Bay B, Gabrielsen A, Knudsen UB. Endometrial preparation methods prior to frozen embryo transfer : A retrospective cohort study comparing true natural cycle, modified natural cycle and artificial cycle. Arch Gynecol Obstet. 2021;1-9.

Mumusoglu S, Polat M, Ozbek LY, Bozdag G, Papanikolaou EG, Esteves SC, et al. Preparation of Endometrium for Frozen Embryo Transfer: A systematic Review. Front Endocrinol. 2021;1-18.

Dieamant F, Petersen CG, Mauri AL, Comar V, Mattila M, Vagnini LD, et al. Single versus sequential culture medium: which is better at improving ongoing pregnancy rates? A systematic review and meta-analysis. JBRA Assisted Reprod. 2017;21(3):240-6.

Schoolcraft WB, Surrey ES, Gardner DK. Embryo transfer: techniques and variables affecting success. Fertility and Sterility. 2001;76(5):863-70.

Tiras B, Polat M, Korucuoglu U, Zeyneloglu HB, Yarali H. Impact of embryo replacement depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril. 2010;94(4):1341-5.

Pope CS, Cook EKD, Arny M, Novak A, Grow DR. Influence of embryo transfer depth on in vitro fertilization and embryo transfer outcomes. Fertil Steril. 2004;81(1):51-8.

Coroleu B, Barri PN, Carreras O, Marti F, Hereter L, Parera N, et al. The influence of the depth of embryo replacement into the uterine cavity on implantation rates after IVF: a controlled, ultrasound-guided study. Hum Reprod. 2002;17(2):341-6.

Tanskate SJ, Nadkarni PK, Nadkarni AA, Singh P. Where is the best site for embryo transfer? A study of relation of embryo-fundal distance with pregnancy rate in ICSI-ET cycle. Int J Reprod Obstet Gynecol. 2016;5(8):2661-5.

Aydin T, Kara M, Turktekin N. Relationship between Endometrial Thickness and In Vitro Fertilization-Intracytoplasmic Sperm Injection Outcome. Fertil Steril. 2013;7(1):29-32.

Holden EC, Dodge LE, Sneeringer R, Moragianni VA, Penzias S, Hacker MR, et al. Thicker endometrial linings are associated with better IVF outcomes: a cohort of 6331 women. Human Fertil. 2017;0(0):1-6.