PDF(Pubmed)
Abstract：
UNASSIGNED: To determine whether endometrial thickness (EMT) differs between i) clomiphene citrate (CC) and gonadotropin (Gn) utilizing patients as their own controls, and ii) patients who conceived with CC and those who did not. Furthermore, to investigate the association between late-follicular EMT and pregnancy outcomes, in CC and Gn cycles.
UNASSIGNED: Retrospective study. Three sets of analyses were conducted separately for the purpose of this study. In analysis 1, we included all cycles from women who initially underwent CC/IUI (CC1, n=1252), followed by Gn/IUI (Gn1, n=1307), to compare EMT differences between CC/IUI and Gn/IUI, utilizing women as their own controls. In analysis 2, we included all CC/IUI cycles (CC2, n=686) from women who eventually conceived with CC during the same study period, to evaluate EMT differences between patients who conceived with CC (CC2) and those who did not (CC1). In analysis 3, pregnancy outcomes among different EMT quartiles were evaluated in CC/IUI and Gn/IUI cycles, separately, to investigate the potential association between EMT and pregnancy outcomes.
UNASSIGNED: In analysis 1, when CC1 was compared to Gn1 cycles, EMT was noted to be significantly thinner [Median (IQR): 6.8 (5.5-8.0) vs. 8.3 (7.0-10.0) mm, p<0.001]. Within-patient, CC1 compared to Gn1 EMT was on average 1.7mm thinner. Generalized linear mixed models, adjusted for confounders, revealed similar results (coefficient: 1.69, 95% CI: 1.52-1.85, CC1 as ref.). In analysis 2, CC1 was compared to CC2 EMT, the former being thinner both before [Median (IQR): 6.8 (5.5-8.0) vs. 7.2 (6.0-8.9) mm, p<0.001] and after adjustment (coefficient: 0.59, 95%CI: 0.34-0.85, CC1 as ref.). In analysis 3, clinical pregnancy rates (CPRs) and ongoing pregnancy rates (OPRs) improved as EMT quartiles increased (Q1 to Q4) among CC cycles (p<0.001, p<0.001, respectively), while no such trend was observed among Gn cycles (p=0.94, p=0.68, respectively). Generalized estimating equations models, adjusted for confounders, suggested that EMT was positively associated with CPR and OPR in CC cycles, but not in Gn cycles.
UNASSIGNED: Within-patient, CC generally resulted in thinner EMT compared to Gn. Thinner endometrium was associated with decreased OPR in CC cycles, while no such association was detected in Gn cycles.
UNASSIGNED: Retrospective study. Three sets of analyses were conducted separately for the purpose of this study. In analysis 1, we included all cycles from women who initially underwent CC/IUI (CC1, n=1252), followed by Gn/IUI (Gn1, n=1307), to compare EMT differences between CC/IUI and Gn/IUI, utilizing women as their own controls. In analysis 2, we included all CC/IUI cycles (CC2, n=686) from women who eventually conceived with CC during the same study period, to evaluate EMT differences between patients who conceived with CC (CC2) and those who did not (CC1). In analysis 3, pregnancy outcomes among different EMT quartiles were evaluated in CC/IUI and Gn/IUI cycles, separately, to investigate the potential association between EMT and pregnancy outcomes.
UNASSIGNED: In analysis 1, when CC1 was compared to Gn1 cycles, EMT was noted to be significantly thinner [Median (IQR): 6.8 (5.5-8.0) vs. 8.3 (7.0-10.0) mm, p<0.001]. Within-patient, CC1 compared to Gn1 EMT was on average 1.7mm thinner. Generalized linear mixed models, adjusted for confounders, revealed similar results (coefficient: 1.69, 95% CI: 1.52-1.85, CC1 as ref.). In analysis 2, CC1 was compared to CC2 EMT, the former being thinner both before [Median (IQR): 6.8 (5.5-8.0) vs. 7.2 (6.0-8.9) mm, p<0.001] and after adjustment (coefficient: 0.59, 95%CI: 0.34-0.85, CC1 as ref.). In analysis 3, clinical pregnancy rates (CPRs) and ongoing pregnancy rates (OPRs) improved as EMT quartiles increased (Q1 to Q4) among CC cycles (p<0.001, p<0.001, respectively), while no such trend was observed among Gn cycles (p=0.94, p=0.68, respectively). Generalized estimating equations models, adjusted for confounders, suggested that EMT was positively associated with CPR and OPR in CC cycles, but not in Gn cycles.
UNASSIGNED: Within-patient, CC generally resulted in thinner EMT compared to Gn. Thinner endometrium was associated with decreased OPR in CC cycles, while no such association was detected in Gn cycles.
摘要：
■为了确定子宫内膜厚度（EMT）在i）柠檬酸克罗米芬（CC）和促性腺激素（Gn）之间是否不同，使用患者作为自己的对照，和ii）受孕CC和未受孕CC的患者。此外，研究晚期卵泡EMT与妊娠结局之间的关系，在CC和Gn周期。
■回顾性研究。为了本研究的目的，分别进行了三组分析。在分析1中，我们纳入了最初接受CC/IUI（CC1，n=1252）的女性的所有周期，其次是Gn/IUI(Gn1，n=1307)，要比较CC/IUI和Gn/IUI之间的EMT差异，利用女性作为自己的控制。在分析2中，我们纳入了所有CC/IUI周期（CC2，n=686），这些周期来自在同一研究期间最终受孕CC的女性，评估受孕CC（CC2）和未受孕CC（CC1）的患者之间的EMT差异。在分析3中，在CC/IUI和Gn/IUI周期中评估了不同EMT四分位数之间的妊娠结局，分开,探讨EMT与妊娠结局之间的潜在关联。
■在分析1中，当CC1与Gn1循环进行比较时，EMT明显变薄[中位数（IQR）：6.8（5.5-8.0）与8.3(7.0-10.0)mm,p<0.001]。患者内，CC1与Gn1EMT相比平均薄1.7mm。广义线性混合模型，针对混杂因素进行了调整，结果相似(系数：1.69，95%CI：1.52-1.85，CC1为参考。).在分析2中，将CC1与CC2EMT进行了比较，前者在[中位数（IQR）：6.8（5.5-8.0）与7.2(6.0-8.9)mm,p<0.001]和调整后(系数：0.59，95CI：0.34-0.85，CC1为参考。).在分析3中，随着CC周期中EMT四分位数的增加（Q1至Q4），临床妊娠率（CPRs）和持续妊娠率（OPR）得到改善（分别为p<0.001，p<0.001），而在Gn周期中没有观察到这种趋势（分别为p=0.94，p=0.68）。广义估计方程模型，针对混杂因素进行了调整，提示在CC周期中EMT与CPR和OPR呈正相关，但不是在Gn周期。
■患者内部，与Gn相比,CC通常导致更薄的EMT。子宫内膜变薄与CC周期中OPR降低有关，而在Gn周期中未检测到这种关联。
■回顾性研究。为了本研究的目的，分别进行了三组分析。在分析1中，我们纳入了最初接受CC/IUI（CC1，n=1252）的女性的所有周期，其次是Gn/IUI(Gn1，n=1307)，要比较CC/IUI和Gn/IUI之间的EMT差异，利用女性作为自己的控制。在分析2中，我们纳入了所有CC/IUI周期（CC2，n=686），这些周期来自在同一研究期间最终受孕CC的女性，评估受孕CC（CC2）和未受孕CC（CC1）的患者之间的EMT差异。在分析3中，在CC/IUI和Gn/IUI周期中评估了不同EMT四分位数之间的妊娠结局，分开,探讨EMT与妊娠结局之间的潜在关联。
■在分析1中，当CC1与Gn1循环进行比较时，EMT明显变薄[中位数（IQR）：6.8（5.5-8.0）与8.3(7.0-10.0)mm,p<0.001]。患者内，CC1与Gn1EMT相比平均薄1.7mm。广义线性混合模型，针对混杂因素进行了调整，结果相似(系数：1.69，95%CI：1.52-1.85，CC1为参考。).在分析2中，将CC1与CC2EMT进行了比较，前者在[中位数（IQR）：6.8（5.5-8.0）与7.2(6.0-8.9)mm,p<0.001]和调整后(系数：0.59，95CI：0.34-0.85，CC1为参考。).在分析3中，随着CC周期中EMT四分位数的增加（Q1至Q4），临床妊娠率（CPRs）和持续妊娠率（OPR）得到改善（分别为p<0.001，p<0.001），而在Gn周期中没有观察到这种趋势（分别为p=0.94，p=0.68）。广义估计方程模型，针对混杂因素进行了调整，提示在CC周期中EMT与CPR和OPR呈正相关，但不是在Gn周期。
■患者内部，与Gn相比,CC通常导致更薄的EMT。子宫内膜变薄与CC周期中OPR降低有关，而在Gn周期中未检测到这种关联。
