Clinical Study
Effect of uterine volume on fresh embryo transfer outcomes in infertile patients with adenomyosis
Li Xiaoxue, Pan Ningning, Zhang Wen, Wang Yang, Ge Yimeng, Wei Hongyi, Ma Caihong
Published 2021-03-25
Cite as Chin J Reprod Contracep, 2021, 41(3): 231-236. DOI: 10.3760/cma.j.cn101441-20200314-00131
Abstract
ObjectiveTo investigate the impact of uterine volume prior to fresh embryo transfer on reproductive outcomes in infertile patients with adenomyosis.
MethodsA retrospective cohort study was conducted for the clinical data of patients diagnosed with adenomyosis and aged ≤40 years undergoing in vitro fertilization/intracytoplasmic sperm injection-embryo transfer (IVF/ICSI-ET) with ultra-long downregulation stimulation protocol in Center for Reproductive Medicine, Department of Obstetrics and Gynecology of Peking University Third Hospital between January 2009 and December 2018. Logistic regression model was used to analyze the correlation between uterine volume and clinical outcomes. Study subjects were divided into three groups based on uterine volume before embryo transfer: group A 56-90 cm3 (equivalent to uterine size within 6 weeks of pregnancy); group B 90-130 cm3 (equivalent to 6-8 weeks gestation); group C ≥130 cm3 (equivalent to uterine size greater than 8 weeks gestation), the effect of uterine volume on clinical outcomes was compared.
ResultsTotally 232 patients were included, 153 patients in group A, 52 patients in group B, 27 patients in group C. The data showed no statistical difference among the three groups in basic characteristics (P>0.05). There was no significant difference in clinical pregnancy rate among three groups (P>0.05). The incidence of miscarriage among three groups were significantly different [group A, 24.59% (15/61); group B, 64.71% (11/17); group C, 55.56% (5/9),P=0.018]. Compared with group A [30.07% (46/153)], the live birth rate of group B [11.54% (6/52)] was significantly reduced (P=0.009). Logistic regression analysis showed that uterine volume before ET was not related to clinical pregnancy rate (OR=0.762, 95% CI=0.481-1.208,P=0.248), and was positively related to miscarriage rate (OR=2.822, 95% CI=1.165-6.835, P=0.022) while negatively correlated with live birth rate (OR=0.458, 95% CI=0.238-0.881, P=0.019).
ConclusionAn increased level of uterine volume prior to embryo transfer (especially larger than 90 cm3) increases miscarriage rate and reduces the live birth rate in infertile patients with adenomyosis. Therefore, controlling uterine volume is still a key to improve the clinical outcome of IVF-ET in adenomyosis patients.
Key words:
Fertilization in vitro; Adenomyosis; Abortion; Live birth; Uterine volume
Contributor Information
Li Xiaoxue
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
Pan Ningning
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
Zhang Wen
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
Wang Yang
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
Ge Yimeng
Peking University School of Basic Medical Sciences, Beijing 100191, China
Wei Hongyi
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
Ma Caihong
Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China
