Endometrial thickness and live birth rates after IVF: a systematic review.

AIM: This study aims to systematically review the current literature on published studies with data on the clinical significance of endometrial thickness on ultrasound for live birth rates after IVF or intracytoplasmic sperm injection (ICSI). METHODS: An extensive systematic review of PubMed, Web of Science, ScienceDirect, Google Scholar, and Open Gray databases, and following hand-search of the reference list of the included studies was performed. RESULTS: We found 20 eligible studies that evaluated 20 546 patients for endometrial thickness, presented risk factors for decreased endometrial receptivity, and IVF outcomes with fresh and frozen embryo transfer (FET) cycles. The mean age of the patients ranged from 28.86 to 41.03 years. Reported endometrial thickness ranged from <4 mm to >15 mm. The clinical pregnancy rate varied from 9,09% to 61,49% in fresh embryo transfer cycles and from 13,3% to 79,31% in FET cycles. Overall, LBR varied between 4,80% and 48,99% in fresh embryo cycles and between 6.06% and 39,19% in FET cycles. LIMITATIONS: Only English-language studies were included; most studies were from the China region; retrospective study design used in most studies; different ET thresholds, which in turn could significantly alter the correlation with pregnancy outcomes; different IVF procedure protocols in fresh or FET cycles. CONCLUSIONS: IVF outcomes in patients with impaired endometrial receptivity do not depend only on the condition of the endometrium. Risk factors and endometrial thickness significantly affect LBR in fresh and FET cycles.

The effectiveness of micronized progesterone in the complex therapy of 'thin endometry' syndrome.

The article presents the results of examination of 30 patients with a history of miscarriage and 'thin' endometrium in comparison with 20 patients without reproductive loss and the presence of normal endometrial thickness. The dynamics of intracellular production of γ-INF, IL-1 and IL-10 by cytotoxic endometrial lymphocytes was studied by flow cytometry. It was found that before treatment in patients with miscarriage and thin endometrium syndrome there was a significant (12-fold) decrease in the level of CD8+ cytotoxic/suppressor lymphocytes (p < .01), a 2.8-fold decrease in the level of CD56+ cells, and also a sharp inhibition of the level of intracellular production of cytokines - γ-INF (8 times), IL-1 (11 times) and IL-10 (15 times). Against the background of complex therapy, including the elimination of pathogenic pathogens, antiplatelet therapy, intrauterine ultrasound cavitation and personalized hormonal therapy using intravaginal micronized progesterone (Luteina), an increase of endometrial thickness was observed: M-echo from 5.9 ± 0.1 to 10.2 ± 0.2 mm; the frequency of visualization of uterine vessels increased to 80-100%; in the spiral arteries, the pulsation index significantly decreased-PI (1.43 ± 0.04 vs. 0.79 ± 0.06), resistance index RI (0.96 ± 0.05 vs. 0.54 ± 0.04), systolic-diastolic ratio S/D in the uterine (4.5 ± 0.04 vs. 2.3 ± 0.05) and arcuate arteries (3.67 ± 0.04 vs. 2.41 ± 0.02); and there was also a positive dynamics of intracellular cytokine production with a significant (p < .05) increase in the level of IL-1 and IL-10, as well as the level of γ-IFN CD56+ by endometrial lymphocytes.