High Endometrial Thickness Does not Affect IVF/ICSI Outcomes

Abstract views: 141 / PDF downloads: 81





Endometrium, IVF/ICSI, live birth rate, pregnancy


Objective: We examined the impact of thicker endometrium (>15 mm) on in vitro fertilization (IVF) outcomes by evaluating the rates of clinical pregnancy, ongoing pregnancy, and live birth. Methods: Intracytoplasmic sperm injection procedures performed at a single IVF center were retrospectively examined. A total of 380 cases from patients aged between 19 and 39 years were included. The patients were divided into 2 groups according to their endometrial thickness (EMT) value determined using ultrasonography on the day of human chorionic gonadotropin administration. Results: Embryo day was 5 in 78.4% of cases with EMT <15 mm and 3 in 89.8% of cases with EMT ≥ 15 mm (p<.001). In the group with EMT <15 mm, IVF outcomes were 61.5% clinical pregnancy, 54.7% ongoing pregnancy, and 49.0% live birth. In the group with EMT > 15 mm, IVF outcomes were 64.3% clinical pregnancy, 52.4% ongoing pregnancy, and 41.7% live birth. There was no significant difference between the groups in terms of clinical pregnancy, ongoing pregnancy, and live birth rates (p>.05). Determining the EMT cut-off value as 14 mm also did not yield significant results. Live birth was present in 47.4% of the cases. There were no statistically significant differences between the groups with and without live birth in terms of the variables examined. Conclusion: There was no significant relationship between EMT and achieving a live birth through IVF. Nevertheless, conducting prospective and comprehensive studies on thicker endometrium may yield data that could be beneficial for IVF practitioners.


Metrics Loading ...


Gao G, Cui X, Li S, Ding P, Zhang S, Zhang Y. Endometrial thickness and IVF cycle outcomes: a meta-analysis. Reprod Biomed Online 2020; 40: 124-33. https://doi.org/10.1016/j.rbmo.2019.09.005

Kasius A, Smit JG, Torrance HL, Eijkemans MJ, Mol BW, Opmeer BC, et al. Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod Update 2014; 20: 530-41. https://doi.org/10.1093/humupd/dmu011

Momeni M, Rahbar MH, Kovanci E. A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles. J Hum Reprod Sci 2011; 4: 130-7. https://doi.org/10.4103/0974-1208.92287

Check J, Lurie D, Dietterich C, Callan C, Baker A. Pregnancy: Adverse effect of a homogeneous hyperechogenic endometrial sonographic pattern, despite adequate endometrial thickness on pregnancy rates following in-vitro fertilization. Hum Reprod 1993; 8: 1293-6. https://doi.org/10.1093/oxfordjournals.humrep.a138244

Liu K, Hartman M, Hartman A, Luo Z-C, Mahutte N. The impact of a thin endometrial lining on fresh and frozen-thaw IVF outcomes: an analysis of over 40 000 embryo transfers. Hum Reprod 2018; 33: 1883-8. https://doi.org/10.1093/humrep/dey281

Ribeiro VC, Santos-Ribeiro S, De Munck N, Drakopoulos P, Polyzos NP, Schutyser V, et al. Should we continue to measure endometrial thickness in modern-day medicine? The effect on live birth rates and birth weight. Reprod Biomed Online 2018; 36: 416-26. https://doi.org/10.1016/j.rbmo.2017.12.016

Yang W, Zhang T, Li Z, Ren X, Huang B, Zhu G, et al. Combined analysis of endometrial thickness and pattern in predicting clinical outcomes of frozen embryo transfer cycles with morphological good-quality blastocyst: A retrospective cohort study. Medicine 2018; 97: e9577. https://doi.org/10.1097/MD.0000000000009577

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 Gynaecol Obstet 2018; 143: 282-8. https://doi.org/10.1002/ijgo.12681

Fang R, Cai L, Xiong F, Chen J, Yang W, Zhao X. The effect of endometrial thickness on the day of hCG administration on pregnancy outcome in the first fresh IVF/ICSI cycle. Gynecol Endocrinol 2016; 32: 473-6. https://doi.org/10.3109/09513590.2015.1132304

Yuan X, Saravelos SH, Wang Q, Xu Y, Li T-C, Zhou C. Endometrial thickness as a predictor of pregnancy outcomes in 10787 fresh IVF-ICSI cycles. Reprod Biomed Online 2016; 33: 197-205. https://doi.org/10.1016/j.rbmo.2016.05.002

Singh N, Bahadur A, Mittal S, Malhotra N, Bhatt A. Predictive value of endometrial thickness, pattern and sub-endometrial blood flows on the day of hCG by 2D doppler in in-vitro fertilization cycles: A prospective clinical study from a tertiary care unit. J Hum Reprod Sci 2011; 4: 29. https://doi.org/10.4103/0974-1208.82357

Kuć P, Kuczyńska A, Topczewska M, Tadejko P, Kuczyński W. The dynamics of endometrial growth and the triple layer appearance in three different controlled ovarian hyperstimulation protocols and their influence on IVF outcomes. Gynecol Endocrinol 2011; 27: 867-73. https://doi.org/10.3109/09513590.2010.540602

Kinay T, Tasci Y, Dilbaz S, Cinar O, Demir B, Haberal A. The relationship between endometrial thickness and pregnancy rates in GnRH antagonist down-regulated ICSI cycles. Gynecol Endocrinol 2010; 26: 833-7. https://doi.org/10.3109/09513590.2010.487591

Al-Ghamdi A, Coskun S, Al-Hassan S, Al-Rejjal R, Awartani K. The correlation between endometrial thickness and outcome of in vitro fertilization and embryo transfer (IVF-ET) outcome. Reprod Biol Endocrinol 2008; 6: 37. https://doi.org/10.1186/1477-7827-6-37

Chen S-L, Wu F-R, Luo C, Chen X, Shi X-Y, Zheng H-Y, et al. Combined analysis of endometrial thickness and pattern in predicting outcome of in vitro fertilization and embryo transfer: a retrospective cohort study. Reprod Biol Endocrinol 2010; 8: 30. https://doi.org/10.1186/1477-7827-8-30

Kumbak B, Erden H, Tosun S, Akbas H, Ulug U, Bahçeci M. Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm. Reprod Biomed Online. 2009; 18: 79-84. https://doi.org/10.1016/S1472-6483(10)60428-2

Yoeli R, Ashkenazi J, Orvieto R, Shelef M, Kaplan B, Bar-Hava I. Significance of increased endometrial thickness in assisted reproduction technology treatments. J Assist Reprod Genet 2004; 21: 285-9. https://doi.org/10.1023/B:JARG.0000043701.22835.56

Ma N-Z, Chen L, Dai W, Bu Z-Q, Hu L-L, Sun Y-P. Influence of endometrial thickness on treatment outcomes following in vitro fertilization/intracytoplasmic sperm injection. Reprod Biol Endocrinol 2017; 15: 5. https://doi.org/10.1186/s12958-016-0222-5

Weissman A, Gotlieb L, Casper RF. The detrimental effect of increased endometrial thickness on implantation and pregnancy rates and outcome in an in vitro fertilization program. Fertil Steril 1999; 71: 147-9. https://doi.org/10.1016/S0015-0282(98)00413-0

Bu Z, Sun Y. The impact of endometrial thickness on the day of human chorionic gonadotrophin (hCG) administration on ongoing pregnancy rate in patients with different ovarian response. PLoS One 2015; 10: e0145703. https://doi.org/10.1371/journal.pone.0145703

Bozdag G, Esinler I, Yarali H. The impact of endometrial thickness and texture on intracytoplasmic sperm injection outcome. J Reprod Med 2009; 54: 303-11.

Dietterich C, Check JH, Choe JK, Nazari A, Lurie D. Increased endometrial thickness on the day of human chorionic gonadotropin injection does not adversely affect pregnancy or implantation rates following in vitro fertilization-embryo transfer. Fertil Steril 2002; 77: 781-6. https://doi.org/10.1016/S0015-0282(01)03276-9

Yuval Y, Lipitz S, Dor J, Achiron R. The relationships between endometrial thickness, and blood flow and pregnancy rates in in-vitro fertilization. Hum Reprod 1999; 14: 1067-71. https://doi.org/10.1093/humrep/14.4.1067

De Geyter C, Schmitter M, De Geyter M, Nieschlag E, Holzgreve W, Schneider HP. Prospective evaluation of the ultrasound appearance of the endometrium in a cohort of 1,186 infertile women. Fertil Steril 2000; 73: 106-13. https://doi.org/10.1016/S0015-0282(99)00484-7

Bassil S. Changes in endometrial thickness, width, length and pattern in predicting pregnancy outcome during ovarian stimulation in in vitro fertilization. Ultrasound in Obstetrics and Gynecology: The Official Journal of the International Society ofUltrasound Obstet Gynecol 2001; 18: 258-63. https://doi.org/10.1046/j.1469-0705.2001.00502.x

Rashidi BH, Sadeghi M, Jafarabadi M, Nejad EST. Relationships between pregnancy rates following in vitro fertilization or intracytoplasmic sperm injection and endometrial thickness and pattern. Eur J Obstet Gynecol Reprod Biol 2005; 120: 179-84. https://doi.org/10.1016/j.ejogrb.2004.08.016

Zhang X, Chen C-H, Confino E, Barnes R, Milad M, Kazer RR. Increased endometrial thickness is associated with improved treatment outcome for selected patients undergoing in vitro fertilization-embryo transfer. Fertil Steril 2005; 83: 336-40. https://doi.org/10.1016/j.fertnstert.2004.09.020

Aboulghar MM, Al-Inany HG, Aboulghar MA, Serour GI, Mansour RT, Amin YM, et al. Three dimensional endometrial volume versus endometrial thickness measurement in prediction of IVF/ICSI outcome. Middle East Fertil Soc J 2005; 10: 63-7.

Richter KS, Bugge KR, Bromer JG, Levy MJ. Relationship between endometrial thickness and embryo implantation, based on 1,294 cycles of in vitro fertilization with transfer of two blastocyst-stage embryos. Fertil Steril 2007; 87: 53-9. https://doi.org/10.1016/j.fertnstert.2006.05.064

Holden EC, Dodge LE, Sneeringer R, Moragianni VA, Penzias AS, Hacker MR. Thicker endometrial linings are associated with better IVF outcomes: a cohort of 6331 women. Hum Fertil 2018; 21: 288-93. https://doi.org/10.1080/14647273.2017.1334130

Zhang T, Li Z, Ren X, Huang B, Zhu G, Yang W, et al. Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: A retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine 2018; 97: e9689. https://doi.org/10.1097/MD.0000000000009689




How to Cite

Yurci, A., Dokuzeylul Gungor, N., & Gurbuz, T. (2021). High Endometrial Thickness Does not Affect IVF/ICSI Outcomes. European Journal of Therapeutics, 27(1), 94–98. https://doi.org/10.5152/eurjther.2021.20102



Original Articles