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Abstract：
BACKGROUND: Myometrial thickness has been expected to be a prognosticator for lower uterine segment function. An abnormal function of the uterine muscle layer can cause common and important reproductive problems. This study aimed to evaluate the relationship between baseline myometrial thickness and assisted reproductive technologies (ART) outcomes.
METHODS: In this prospective cohort study, 453 infertile women undergoing ART cycles without any obvious uterine pathology, participated in this prospective cohort study from February 2013 to May 2015. In order to measure the myometrial thickness in the anterior and posterior of the uterine, trans-vaginal ultrasounds were conducted on days 2-4 of the cycle (menstrual phase) preceding ovarian stimulation and the day of human chorionic gonadotropin (hCG) injection. We defined three groups based on the baseline myometrial thickness in the anterior and posterior, including (A) <25 mm, (B) 25-29.9 mm and (C) ≥30 mm. Ovarian stimulation, oocyte retrieval and luteal phase support were performed in accordance with the standard long protocol. Two weeks after embryo transfer, the patients underwent a pregnancy test by checking their serum β-hCG levels. The primary outcome measure was clinical pregnancy rate. Secondary outcome measures were, implantation rate, abortion rate and live birth rate.
RESULTS: The clinical pregnancy (P=0.013) and implantation (P=0.003) rates were significantly lower in group A than in two other groups. Although the live birth rate was lower in group A than two other groups, this decrease was not statistically significant (P=0.058).
CONCLUSIONS: The findings may be a way for clinicians to draw focus on providing therapeutic strategies and a specific supportive care for women with a baseline myometrial thickness <25 mm in order to improve the reproductive outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI).
METHODS: In this prospective cohort study, 453 infertile women undergoing ART cycles without any obvious uterine pathology, participated in this prospective cohort study from February 2013 to May 2015. In order to measure the myometrial thickness in the anterior and posterior of the uterine, trans-vaginal ultrasounds were conducted on days 2-4 of the cycle (menstrual phase) preceding ovarian stimulation and the day of human chorionic gonadotropin (hCG) injection. We defined three groups based on the baseline myometrial thickness in the anterior and posterior, including (A) <25 mm, (B) 25-29.9 mm and (C) ≥30 mm. Ovarian stimulation, oocyte retrieval and luteal phase support were performed in accordance with the standard long protocol. Two weeks after embryo transfer, the patients underwent a pregnancy test by checking their serum β-hCG levels. The primary outcome measure was clinical pregnancy rate. Secondary outcome measures were, implantation rate, abortion rate and live birth rate.
RESULTS: The clinical pregnancy (P=0.013) and implantation (P=0.003) rates were significantly lower in group A than in two other groups. Although the live birth rate was lower in group A than two other groups, this decrease was not statistically significant (P=0.058).
CONCLUSIONS: The findings may be a way for clinicians to draw focus on providing therapeutic strategies and a specific supportive care for women with a baseline myometrial thickness <25 mm in order to improve the reproductive outcome of in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI).
摘要：
背景：子宫肌层厚度被认为是子宫下段功能的预测指标。子宫肌层的功能异常可引起常见和重要的生殖问题。本研究旨在评估基线子宫肌层厚度与辅助生殖技术（ART）结局之间的关系。
方法：在这项前瞻性队列研究中，453例接受ART周期无明显子宫病理的不孕妇女，参加了2013年2月至2015年5月的前瞻性队列研究.为了测量子宫前后的子宫肌层厚度，在卵巢刺激前的周期（月经期）和人绒毛膜促性腺激素（hCG）注射当天的第2-4天进行经阴道超声检查。我们根据前后的基线子宫肌层厚度定义了三组，包括(A)<25mm，(B)25-29.9毫米，(C)≥30毫米。卵巢刺激,根据标准长方案进行卵母细胞回收和黄体期支持.胚胎移植后两周，患者通过检测血清β-hCG水平进行妊娠试验.主要结局指标是临床妊娠率。次要结果指标是，植入率,流产率和活产率。
结果：A组的临床妊娠率（P=0.013）和种植率（P=0.003）明显低于其他两组。尽管A组的活产率低于其他两组，这一下降无统计学意义(P=0.058).
结论：这些发现可能是临床医生关注为基线子宫肌层厚度<25mm的女性提供治疗策略和特定支持护理的一种方式，以改善体外受精/卵胞浆内单精子注射（IVF-ICSI）的生殖结局。
方法：在这项前瞻性队列研究中，453例接受ART周期无明显子宫病理的不孕妇女，参加了2013年2月至2015年5月的前瞻性队列研究.为了测量子宫前后的子宫肌层厚度，在卵巢刺激前的周期（月经期）和人绒毛膜促性腺激素（hCG）注射当天的第2-4天进行经阴道超声检查。我们根据前后的基线子宫肌层厚度定义了三组，包括(A)<25mm，(B)25-29.9毫米，(C)≥30毫米。卵巢刺激,根据标准长方案进行卵母细胞回收和黄体期支持.胚胎移植后两周，患者通过检测血清β-hCG水平进行妊娠试验.主要结局指标是临床妊娠率。次要结果指标是，植入率,流产率和活产率。
结果：A组的临床妊娠率（P=0.013）和种植率（P=0.003）明显低于其他两组。尽管A组的活产率低于其他两组，这一下降无统计学意义(P=0.058).
结论：这些发现可能是临床医生关注为基线子宫肌层厚度<25mm的女性提供治疗策略和特定支持护理的一种方式，以改善体外受精/卵胞浆内单精子注射（IVF-ICSI）的生殖结局。
