Investigating the effect of endometrial thickness changes and compaction on the fertility rate in patients undergoing ART: A prospective study

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Based on this, it has been shown that endometrial compaction affect fertility success in patients. In this study, the impact of endometrial compaction on pregnancy outcomes has been evaluated. Material and methods: This prospective cohort study included 250 patients undergoing embryo transfer, who referred to the infertility center of Shariati Hospital in Tehran between 2021–2022. They were examined from the point of view of the relationship between endometrial thickness changes and fertility rate in FET and Fresh cycles. After preparing the endometrium, its thickness was evaluated by ultrasound. Result: The results showed that the percentage of chemical and clinical pregnancy in the compact group was higher compared to the non-compact one, which was statistically significant (p < 0.05). The rate of pregnancy in four groups of 5, 10, 15, and %20 compaction was 77(30.4%), 49(19.4%), 28(11.1%), and 14(5.5%), respectively. Conclusion: Finally, endometrial compaction can be associated with an increase in chemical and clinical pregnancy rate in infertile patients. In addition, secondary thickness has predictive value for clinical pregnancy. Endometrial Thickness Fertility Rate Assisted Reproductive Technology Figures Figure 1 Figure 2 Introduction Infertility is one of the disorders that affects many couples of the reproductive age. Today, the use of Assisted Reproductive Technology (ART) to treat infertile patients has expanded ( 1 ). In order to increase the success rate of ART, many researches are being conducted. Endometrial characteristics are one of the main factors that can affect the ART success. Previous studies have been shown that there is a direct relationship between the thickness of the endometrium and the fertility rate using ART ( 2 ). Based on this, an endometrium thickness of less than 7 mm can be considered a thin endometrium, which can be associated with adverse perinatal outcomes, miscarriage, or abnormal placentation. Therefore, currently most studies have observed that thin endometrium has an adverse effect on pregnancy outcome during in vitro fertilization (IVF) treatment, even though its specific mechanism is not well understood ( 3 – 5 ). The results of published studies that evaluated the effect of endometrial thickness on the favorable outcomes of ART patients are completely heterogeneous. Some studies have observed a decrease in pregnancy and live birth rate in relation to low endometrial thickness ( 6 – 8 ). But other studies have not observed any similar relationships ( 9 ). There are only a few studies that have evaluated the effect of endometrial thickness on frozen embryo transfer (FET) cycles. Therefore, this study was designed according to the mentioned points and many uncertainties. The present study also investigates the relationship between the thickness of the endometrium and its compaction with the fertility rate after embryo transfer; we hope that our findings help to remove obstacles to successful reproduction and increase the chance of live birth in patients using assisted reproduction methods. Material and method The studied population in this prospective cohort was 250 patients undergoing embryo transfer, who referred to the infertility center of Shariati Hospital in Tehran between 2021–2022. They were examined from the point of view of the relationship between endometrial thickness changes and fertility rates in FET and Fresh cycles. All referred patients were entered into the study, provided they met the entry criteria and consented to participate until the desired sample size was reached. Inclusion and Exclusion criteria Inclusion criteria were patient satisfaction, the age range of 18–40 years, individuals with single blastocyst transfer, the endometrial pattern of A/B on the day of progesterone administration, and pattern C on the day of embryo transfer. Exclusion criteria included the mother suffering from high blood pressure, diabetes, and anatomical problems of the uterus and the impossibility of measuring the thickness of the endometrium in ultrasound evaluation, low-quality embryos (blastocyst score less than 3 BC according to the Gardner system), and patients with thin endometrial thickness (< 7 mm per day of progesterone administration). Primary outcome Ongoing pregnancy was defined as the live birth or the activity of the fetal heart in transvaginal ultrasound at or after 12 weeks of gestation. Endometrial preparation and patient follow-up Endometrial preparation included administration of estrogen/progesterone (EP) and natural cycle (NC). In patients under hormone therapy, the protocol started with exogenous E2 on day 2–3 of the normal cycle, or GnRH agonist was started in the previous luteal phase and exogenous E2 on day 2–3 of the next cycle. Patients with endometriosis were generally treated with depot leuprolide acetate with estrogen and progesterone for at least 2 months before ET. In all cases, patients were given oral or vaginal administration (as determined by the physician) of 2 mg of micronized E2 twice daily, which was increased to 4 mg twice daily after 5 days. Ultrasound measurement of endometrial thickness was done 10 days after the start of E2 to measure the thickness and pattern of the endometrium. A higher thickness equal to 7 mm and a trilaminar pattern of the endometrium were considered sufficient to start progesterone administration. If it was insufficient, estrogen administration was continued and serial ultrasound evaluation was performed until the adequate endometrium was observed. Patients with endometrial thickness less than 7 mm were canceled and excluded from the analysis. The patients started progesterone injection (50 mg daily intramuscularly) or vaginal progesterone inside the body (For patients in normal cycle, injectable progesterone (40 mg) was prescribed on the day of ovulation) when the thickness of the endometrium reached greater than or equal to 7 mm. The measured thickness of the endometrium was recorded on this day, and then the embryos were weighed and transferred on day 6 of progesterone administration. On the day of embryo transfer under ultrasound guidance, the ultrasound technician measured the thickness of the endometrium vaginally and recorded the endometrial images. All blastocysts were evaluated before embryo transfer by an experienced embryologist using the grading system proposed by Gardner ( 10 ). Each embryo was also graded according to the Society for Assisted Reproductive Technology simplified grading system proposed by Heitmann et al ( 11 ). To measure the thickness of the endometrium on the day of embryo transfer, the ultrasound images taken by the ultrasound technician were retrieved using the imaging software, and the best image showing the longitudinal section of the endometrium including the cervical canal was measured. In cases where the image did not include the cervical canal or the measurement could not be accurately performed, the patient was excluded from the data analysis. Serum β-hCG levels were assessed for all patients 14 to 16 days after ET to confirm the biochemical pregnancy. If pregnancy was achieved, progesterone support continued until the end of the twelfth week of pregnancy. Also, clinical pregnancy was confirmed by ultrasound in 5 weeks. Patients were divided into two groups based on the calculation of the difference in endometrial thickness measurement between the day of embryo transfer and the last ultrasound during progesterone administration: 1) those whose endometrial thickness at the time of embryo transfer compared to the first day of progesterone administration, 5%, 10%, 15% or 20% reduction, and 2) those who had an increase in endometrial thickness or a decrease in thickness of less than 5%, 10%, or 15%. Statistical Analysis: Continuous variables were reported as mean ± standard deviation (SD). Categorical variables were expressed as absolute frequency and frequency percentage. Sharpino-Wilk test was used to check the normal distribution of quantitative variables. Based on this, student t-test or Mann-Whitney U test were performed for quantitative variables and the chi-square test for qualitative variables. ROC curve analysis was used to estimate the discriminating potential of ET between the groups of studied subjects. Youden's method was also used to identify the optimal threshold. For this purpose, med calc v19.7 software was used. All statistical analyses were performed in SPSS software version 24 and a P-value of less than 0.05 was considered significant for all statistical tests. Results General characteristics of patients In the present study, uterine thickness on the first day of progesterone administration (primary thickness) and ET day (secondary thickness) was evaluated by vaginal ultrasound in 253 women who underwent FET or fresh cycles. The presence or absence of compaction, and compaction of 5, 10, 15 and 20% were evaluated in these patients. The basic and clinical characteristics of patients with or without compaction are given in Table 1 . The comparison of demographic and clinical characteristics of patients between these two groups did not show any significant difference. Table 1 Patient characteristics in total and by group (compacted vs. not compacted) parameter Total (N = 253) Compact (N = 93) no compaction (N = 160) P-value Embryo Frozen–thaw 193(76.3) 73(78.5) 120(75) 0.64 Fresh 60(23.7) 20(21.5) 40(25) Etiologies PCD 53(20.9) 18(19.6) 35(21.9) 0.62 Male factor 59(23.3) 26(28) 33(20.6) Tubal factor 13(5.1) 3(3.2) 10(6.3) Septum 3(1.2) 1(1.1) 2(1.3) Endometriosis 27(10.7) 12(12.9) 15(9.4) Amenorrhea 3(1.2) 1(1.1) 2(1.3) Low ovarian reserve 68(26.9) 20(21.5) 48(30) Salpingectomy 5( 2 ) 3(3.2) 2(1.3) Unknown 22(8.7) 9(9.7) 13(8.1) ART.Hx IUI 76(30) 28(30.1) 48(30) 0.97 IVF 75(29.6) 29(31.2) 46(28.8) Other 29(11.5) 10(10.8) 19(11.9) No.Hx 73(28.9) 26(28) 47(29.4) Medical.Hx Hypothyroidism 51(20.2) 25(26.9) 26(16.3) 0.23 Thrombophilia 3(1.2) 1(1.1) 2(1.3) DM 4(1.6) 0(0) 4(2.5) Myomectomy 2(0.8) 1(1.1) 1(0.6) Cardiovascular 1(0.4) 0(0) 1(0.6) No.Hx 192(75.9) 66(71) 126(78.8) Menses Regular 206(81.4) 74(79.6) 132(82.5) 0.81 Irregular 47(18.6) 19(20.4) 28(17.5) HSG findings Normal 224(88.5) 81(87.1) 143(89.4) 0.68 Abnormal 29(11.5) 12(12.9) 17(10.6) Female age(year) 33.02 ± 5.92 33.11 ± 5.83 32.96 ± 6 0.84 Male age(year) 37.26 ± 6.46 37.51 ± 7.69 37.12 ± 5.64 0.66 Female height(cm) 162.16 ± 6.72 162.34 ± 6.28 162.06 ± 6.98 0.74 Female weight(Kg) 69.18 ± 13.21 67.9 ± 10.61 69.93 ± 14.49 0.2 Female BMI(Kg/m 2 ) 26.33 ± 5.01 25.8 ± 4.02 26.65 ± 5.49 0.16 FSH(mIU/mL) 7.82 ± 4.86 7.65 ± 3.71 7.91 ± 5.43 0.66 AMH(ng/ml) 3.85 ± 4.36 4.1 ± 4.1 3.7 ± 4.5 0.5 LH(IU/mL) 6.63 ± 4.88 6.14 ± 3.62 6.92 ± 5.49 0.21 Estradiol(pg/mL) 61.44 ± 48.98 66.97 ± 47.47 57.51 ± 50.01 0.3 TSH(mIU/L) 2.08 ± 1.15 2.06 ± 1.16 2.1 ± 1.15 0.79 prolactin(µg/L) 139.77 ± 212.2 163.56 ± 205.9 126.56 ± 218.3 0.58 primary endometrial thickness(mm) 9.69 ± 1.64 9.51 ± 1.57 10 ± 1.71 0.02 secondary endometrial thickness(mm) 10.24 ± 2.15 8.76 ± 1.62 11.10 ± 1.95 0.0001 * Qualitative parameters are given as number (%) and quantitative parameters are given as mean ± standard deviation. Association of endometrial compaction with chemical and clinical pregnancy rate In this part of the study, the association between the presence or absence of endometrial compaction with the rate of chemical pregnancy and clinical pregnancy was investigated. The chemical pregnancy rate in this study was 99(39.13%), 21(35%) of fresh embryos and 78(40%) of FETs, and the clinical pregnancy rate was 71(28.06%). The results showed that both chemical and clinical pregnancy have a significant association with compact endometrium. Table 2 shows the incidence rate of pregnancy in two groups. Table 2 Comparison of chemical and clinical pregnancy rate between compact and non-compact groups parameter Compact (N = 93) no compaction (N = 160) P-value Chemical pregnancy Positive 51(54.8) 48(30) 0.0001 Negative 42(45.2) 112(70) clinical pregnancy Positive 37(39.8) 34(21.3) 0.001 Negative 56(60.2) 126(78.8) Association of endometrial compaction percentage with chemical and clinical pregnancy In this part of the study, the association of the percentage of endometrial compaction with the rate of chemical and clinical pregnancy was evaluated. Based on our analysis, all the percentages of compaction have a significant association with the occurrence of chemical and clinical pregnancy (Table 3 ). Table 3 Comparison of chemical and clinical pregnancy rate in different percent of compaction parameter Chemical pregnancy Clinical pregnancy P-value (Chemical) (Clinical) Positive Negative Positive Negative 5 percent compaction Yes(N = 77) 44(44.4) 33(21.4) 37(52.1) 40(22) 0.0001 0.0001 No(N = 176) 55(55.6) 121(78.6) 34(47.9) 142(78) 10 percent compaction Yes(N = 49) 35(35.4) 14(9.1) 32(45.1) 17(9.3) 0.0001 0.0001 No(N = 204) 64(64.4) 140(90.9) 39(54.9) 165(90.7) 15 percent compaction Yes(N = 28) 23(23.2) 5(3.2) 22(31) 6(3.3) 0.0001 0.0001 No(N = 225) 76(76.8) 149(96.8) 49(69) 176(96.7) 20 percent compaction Yes(N = 14) 13(13.1) 1(0.6) 13(18.3) 1(0.5) 0.0001 0.0001 No(N = 239) 86(86.9) 153(99.4) 58(81.7) 181(99.5) Association of primary and secondary endometrial thickness with chemical and clinical pregnancy and ROC curve analysis In this part of the study, primary and secondary endometrial thickness was compared between people with and without chemical and clinical pregnancy separately. The results showed that only secondary thickness (thickness measured on the day of embryo transfer) had a significant difference between people with positive and negative clinical pregnancies. So in people with positive clinical pregnancy, the thickness of the endometrium was less (Table 4 , Fig. 1 ). Also, the predictive power of secondary endometrial thickness was evaluated in clinical pregnancy prediction. Based on this, this parameter has an acceptable power in predicting clinical pregnancy. Figure 2 shows the area under the curve (AUC) in this regard (AUC = 0.59, P-value = 0.01). Table 4 association of endometrial thickness with chemical and clinical thickness Chemical pregnancy Mean ± SD P-value primary endometrial thickness Positive(N = 99) 9.79 ± 1.63 0.16 Negative(N = 154) 9.49 ± 1.64 secondary endometrial thickness Positive(N = 99) 10.09 ± 2.03 0.14 Negative(N = 154) 10.51 ± 2.35 Clinical pregnancy Mean ± SD P-value primary endometrial thickness Positive(N = 71) 9.79 ± 1.63 0.25 Negative(N = 182) 9.55 ± 1.64 secondary endometrial thickness Positive(N = 71) 9.92 ± 1.97 0.006 Negative(N = 182) 10.67 ± 2.33 Discussion Today, the thickness of the endometrium as a key factor affects the pregnancy outcomes in infertile patients. Based on this, it has been shown that endometrial compaction can affect on increasing the fertility success in patients ( 7 ). In the present study, the results showed that the percentage of chemical and clinical pregnancy was higher in the compacted group compared to the non-compacted one, which was statistically significant. In terms of chemical and clinical pregnancy, 74.2% were positive in the compacted group and 60% in the non-compacted group. In addition, in terms of clinical pregnancy, 48.8% were positive in the non-compacted cases. Youngster and his colleagues showed that the ratio of clinical and ongoing pregnancy was higher in the compacted group, which was consistent with the present study ( 12 ). Also, Ju et al. showed that the percentage of clinical pregnancy was higher in the compacted group In this study, clinical pregnancy evaluation was done in patients undergoing frozen-thaw embryo transfer (FET) cycle ( 13 ). In another study, it was shown that live birth is directly related to endometrial compaction; so that, the incidence of live birth was higher in the compacted group.( 14 ). During the menstrual cycle, in the follicular phase, the secretion of estrogen causes the growth and proliferation of endometrial cells, as well as the formation of blood vessels. Following ovulation, the secretion of progesterone stops the endometrial volume increment. However, it does not stop the thickening of the endometrium, and the growth of blood vessels continues ( 15 , 16 ). Several studies have shown that pregnancy outcomes are affected by the percentage of endometrial compaction ( 17 ). In the present study, the amount of endometrial compaction was evaluated in percentages of 5, 10, 15 and 20. The rate of pregnancy in four groups of %5, %10, %15, and %20 compaction was 77(30.4%), 49(19.4%), 28(11.1%), and 14(5.5%), respectively. Haas et al. showed that with the increase of endometrial compaction from 5–10%, the rate of clinical and ongoing pregnancy increased ( 18 ). Youngster and his colleagues showed that the clinical and chemical pregnancy rate was higher in the compacted group with 10 and 15% compared to 5%. Further investigations showed that an increase of more than 10% compaction does not have much effect on the clinical and chemical pregnancy rate ( 12 ). Their results were not consistent with the present study. Thhis inconsistency can be due to the number of patients examined and the days of measurement after embryo transfer. On the other hand, in the present study only secondary thickness has predictive value for clinical pregnancy. Meanwhile, various studies measured the thickness of the endometrium on different days after embryo transfer and reported its different effects on pregnancy outcomes. This study also had a series of limitations; one of which was not evaluating the thickness of the endometrium on different days after embryo transfer. On the other hand, more studies should be done on the bigger populations in the future. Conclusion According to the main results of this study, endometrial compaction has a significant effect on the rate of chemical and clinical pregnancy. Although, in this study, all the percentages of compaction had a significant association with pregnancy, no significant superiority was observed in a particular percentage of compaction. On the other hand, the results showed that the thickness of the endometrium on the day of embryo transfer, regardless of compaction had a definite effect on pregnancy success; it is also a valuable predictive factor. Declarations Acknowledgements We wish thank you of all our colleague in Tehran university of medical science. Conflict of interest The authors declare that they have no conflict of interest. Author contribution Marzieh Aghahosseini, Ashraf Aleyassin, Sedigheh Hosseinimousa design the manuscript. Atoosa Etezadi, Ayda Najafian, and Fatemeh Sarvi write the manuscript. Maryam Shabani Nashtaee analysis data. Data availability Data availability is corresponding author responsibility. Ethical approval All the procedures performed in the studies involving human participants were in accordance with the ethical standards of the local ethics committee of Tehran university of medical science (IR.TUMS.SHARIATI.REC.1401.013), as well as the 1964 Helsinki declaration. Consent for publication Not applicable. Funding Non References Andrus M (2020) Exhibition and film about miscarriage, infertility, and stillbirth: Art therapy implications. Art therapy 37(4):169–176 Fujimoto A, Ichinose M, Harada M, Hirata T, Osuga Y, Fujii T (2014) The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer. J Assist Reprod Genet 31:1189–1194 Bu Z, Wang K, Dai W, Sun Y (2016) Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles. 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J Clin Endocrinol Metabolism 70(2):437–443 Moreno I, Codoñer FM, Vilella F, Valbuena D, Martinez-Blanch JF, Jimenez-Almazán J et al (2016) Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol 215(6):684–703 Chen X-T, Sun Z-G, Song J-Y (2023) Does endometrial compaction before embryo transfer affect pregnancy outcomes? a systematic review and meta-analysis. Front Endocrinol. ;14 Haas J, Smith R, Zilberberg E, Nayot D, Meriano J, Barzilay E et al (2019) Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers. Fertil Steril 112(3):503–509e1 Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4009419","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":278447170,"identity":"520fb04c-d246-4970-b022-9d9bbbaaafa3","order_by":0,"name":"Atoosa Etezadi","email":"","orcid":"","institution":"","correspondingAuthor":false,"prefix":"","firstName":"Atoosa","middleName":"","lastName":"Etezadi","suffix":""},{"id":278447171,"identity":"6d4d2a4c-c44a-4126-aa90-06efdf8d1f2d","order_by":1,"name":"Marzieh 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thickness with chemical and clinical thickness\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-4009419/v1/ffa32262cc63218b33e01126.png"},{"id":52623089,"identity":"87f1b6bc-19ba-4d0a-9b1f-1f51c320ceb0","added_by":"auto","created_at":"2024-03-13 17:17:56","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":12707,"visible":true,"origin":"","legend":"\u003cp\u003eRoc curve analysis for predictive value of endometrial thickness on the day of embryo transfer for predicting of clinical pregnancy.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-4009419/v1/28a6508c20f68bc4def60605.png"},{"id":58009484,"identity":"d053f9c2-d1fa-468e-be99-409bdaf5b115","added_by":"auto","created_at":"2024-06-09 21:22:14","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":735590,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4009419/v1/8a2969b8-fd41-48ca-85e9-49e098a0bd13.pdf"}],"financialInterests":"","formattedTitle":"Investigating the effect of endometrial thickness changes and compaction on the fertility rate in patients undergoing ART: A prospective study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInfertility is one of the disorders that affects many couples of the reproductive age. Today, the use of Assisted Reproductive Technology (ART) to treat infertile patients has expanded (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). In order to increase the success rate of ART, many researches are being conducted. Endometrial characteristics are one of the main factors that can affect the ART success. Previous studies have been shown that there is a direct relationship between the thickness of the endometrium and the fertility rate using ART (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Based on this, an endometrium thickness of less than 7 mm can be considered a thin endometrium, which can be associated with adverse perinatal outcomes, miscarriage, or abnormal placentation. Therefore, currently most studies have observed that thin endometrium has an adverse effect on pregnancy outcome during in vitro fertilization (IVF) treatment, even though its specific mechanism is not well understood (\u003cspan additionalcitationids=\"CR4\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe results of published studies that evaluated the effect of endometrial thickness on the favorable outcomes of ART patients are completely heterogeneous. Some studies have observed a decrease in pregnancy and live birth rate in relation to low endometrial thickness (\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). But other studies have not observed any similar relationships (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). There are only a few studies that have evaluated the effect of endometrial thickness on frozen embryo transfer (FET) cycles. Therefore, this study was designed according to the mentioned points and many uncertainties. The present study also investigates the relationship between the thickness of the endometrium and its compaction with the fertility rate after embryo transfer; we hope that our findings help to remove obstacles to successful reproduction and increase the chance of live birth in patients using assisted reproduction methods.\u003c/p\u003e"},{"header":"Material and method","content":"\u003cp\u003eThe studied population in this prospective cohort was 250 patients undergoing embryo transfer, who referred to the infertility center of Shariati Hospital in Tehran between 2021\u0026ndash;2022. They were examined from the point of view of the relationship between endometrial thickness changes and fertility rates in FET and Fresh cycles. All referred patients were entered into the study, provided they met the entry criteria and consented to participate until the desired sample size was reached.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInclusion and Exclusion criteria\u003c/b\u003e \u003c/p\u003e \u003cp\u003eInclusion criteria were patient satisfaction, the age range of 18\u0026ndash;40 years, individuals with single blastocyst transfer, the endometrial pattern of A/B on the day of progesterone administration, and pattern C on the day of embryo transfer. Exclusion criteria included the mother suffering from high blood pressure, diabetes, and anatomical problems of the uterus and the impossibility of measuring the thickness of the endometrium in ultrasound evaluation, low-quality embryos (blastocyst score less than 3 BC according to the Gardner system), and patients with thin endometrial thickness (\u0026lt;\u0026thinsp;7 mm per day of progesterone administration).\u003c/p\u003e \u003cp\u003e \u003cb\u003ePrimary outcome\u003c/b\u003e \u003c/p\u003e \u003cp\u003eOngoing pregnancy was defined as the live birth or the activity of the fetal heart in transvaginal ultrasound at or after 12 weeks of gestation.\u003c/p\u003e \u003cp\u003e \u003cb\u003eEndometrial preparation and patient follow-up\u003c/b\u003e \u003c/p\u003e \u003cp\u003eEndometrial preparation included administration of estrogen/progesterone (EP) and natural cycle (NC). In patients under hormone therapy, the protocol started with exogenous E2 on day 2\u0026ndash;3 of the normal cycle, or GnRH agonist was started in the previous luteal phase and exogenous E2 on day 2\u0026ndash;3 of the next cycle. Patients with endometriosis were generally treated with depot leuprolide acetate with estrogen and progesterone for at least 2 months before ET. In all cases, patients were given oral or vaginal administration (as determined by the physician) of 2 mg of micronized E2 twice daily, which was increased to 4 mg twice daily after 5 days.\u003c/p\u003e \u003cp\u003eUltrasound measurement of endometrial thickness was done 10 days after the start of E2 to measure the thickness and pattern of the endometrium. A higher thickness equal to 7 mm and a trilaminar pattern of the endometrium were considered sufficient to start progesterone administration. If it was insufficient, estrogen administration was continued and serial ultrasound evaluation was performed until the adequate endometrium was observed. Patients with endometrial thickness less than 7 mm were canceled and excluded from the analysis. The patients started progesterone injection (50 mg daily intramuscularly) or vaginal progesterone inside the body (For patients in normal cycle, injectable progesterone (40 mg) was prescribed on the day of ovulation) when the thickness of the endometrium reached greater than or equal to 7 mm. The measured thickness of the endometrium was recorded on this day, and then the embryos were weighed and transferred on day 6 of progesterone administration.\u003c/p\u003e \u003cp\u003eOn the day of embryo transfer under ultrasound guidance, the ultrasound technician measured the thickness of the endometrium vaginally and recorded the endometrial images. All blastocysts were evaluated before embryo transfer by an experienced embryologist using the grading system proposed by Gardner (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Each embryo was also graded according to the Society for Assisted Reproductive Technology simplified grading system proposed by Heitmann et al (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). To measure the thickness of the endometrium on the day of embryo transfer, the ultrasound images taken by the ultrasound technician were retrieved using the imaging software, and the best image showing the longitudinal section of the endometrium including the cervical canal was measured. In cases where the image did not include the cervical canal or the measurement could not be accurately performed, the patient was excluded from the data analysis. Serum β-hCG levels were assessed for all patients 14 to 16 days after ET to confirm the biochemical pregnancy. If pregnancy was achieved, progesterone support continued until the end of the twelfth week of pregnancy.\u003c/p\u003e \u003cp\u003eAlso, clinical pregnancy was confirmed by ultrasound in 5 weeks. Patients were divided into two groups based on the calculation of the difference in endometrial thickness measurement between the day of embryo transfer and the last ultrasound during progesterone administration: 1) those whose endometrial thickness at the time of embryo transfer compared to the first day of progesterone administration, 5%, 10%, 15% or 20% reduction, and 2) those who had an increase in endometrial thickness or a decrease in thickness of less than 5%, 10%, or 15%.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis:\u003c/h2\u003e \u003cp\u003eContinuous variables were reported as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD). Categorical variables were expressed as absolute frequency and frequency percentage. Sharpino-Wilk test was used to check the normal distribution of quantitative variables. Based on this, student t-test or Mann-Whitney U test were performed for quantitative variables and the chi-square test for qualitative variables. ROC curve analysis was used to estimate the discriminating potential of ET between the groups of studied subjects. Youden's method was also used to identify the optimal threshold. For this purpose, med calc v19.7 software was used. All statistical analyses were performed in SPSS software version 24 and a P-value of less than 0.05 was considered significant for all statistical tests.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e \u003cb\u003eGeneral characteristics of patients\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn the present study, uterine thickness on the first day of progesterone administration (primary thickness) and ET day (secondary thickness) was evaluated by vaginal ultrasound in 253 women who underwent FET or fresh cycles. The presence or absence of compaction, and compaction of 5, 10, 15 and 20% were evaluated in these patients. The basic and clinical characteristics of patients with or without compaction are given in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The comparison of demographic and clinical characteristics of patients between these two groups did not show any significant difference.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatient characteristics in total and by group (compacted vs. not compacted)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eparameter\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eTotal (N\u0026thinsp;=\u0026thinsp;253)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eCompact (N\u0026thinsp;=\u0026thinsp;93)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eno compaction (N\u0026thinsp;=\u0026thinsp;160)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEmbryo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrozen\u0026ndash;thaw\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e193(76.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e73(78.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e120(75)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFresh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60(23.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40(25)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003eEtiologies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53(20.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18(19.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35(21.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"8\" rowspan=\"9\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale factor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e59(23.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26(28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e33(20.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTubal factor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13(5.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10(6.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeptum\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(1.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEndometriosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27(10.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12(12.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15(9.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAmenorrhea\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(1.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLow ovarian reserve\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e68(26.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20(21.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48(30)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSalpingectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(1.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUnknown\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22(8.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9(9.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13(8.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eART.Hx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIUI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76(30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28(30.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48(30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIVF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e75(29.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29(31.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e46(28.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10(10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19(11.9)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo.Hx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73(28.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26(28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e47(29.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003eMedical.Hx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHypothyroidism\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51(20.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25(26.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26(16.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"5\" rowspan=\"6\"\u003e \u003cp\u003e0.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThrombophilia\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(1.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4(2.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMyomectomy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(0.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCardiovascular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0(0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(0.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo.Hx\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e192(75.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66(71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e126(78.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMenses\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRegular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e206(81.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e74(79.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e132(82.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIrregular\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47(18.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19(20.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28(17.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHSG findings\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e224(88.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e81(87.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e143(89.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAbnormal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29(11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12(12.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17(10.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFemale age(year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.02\u0026thinsp;\u0026plusmn;\u0026thinsp;5.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33.11\u0026thinsp;\u0026plusmn;\u0026thinsp;5.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32.96\u0026thinsp;\u0026plusmn;\u0026thinsp;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMale age(year)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.26\u0026thinsp;\u0026plusmn;\u0026thinsp;6.46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.51\u0026thinsp;\u0026plusmn;\u0026thinsp;7.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37.12\u0026thinsp;\u0026plusmn;\u0026thinsp;5.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFemale height(cm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e162.16\u0026thinsp;\u0026plusmn;\u0026thinsp;6.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e162.34\u0026thinsp;\u0026plusmn;\u0026thinsp;6.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e162.06\u0026thinsp;\u0026plusmn;\u0026thinsp;6.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFemale weight(Kg)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69.18\u0026thinsp;\u0026plusmn;\u0026thinsp;13.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e67.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e69.93\u0026thinsp;\u0026plusmn;\u0026thinsp;14.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFemale BMI(Kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.33\u0026thinsp;\u0026plusmn;\u0026thinsp;5.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.8\u0026thinsp;\u0026plusmn;\u0026thinsp;4.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.65\u0026thinsp;\u0026plusmn;\u0026thinsp;5.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFSH(mIU/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.82\u0026thinsp;\u0026plusmn;\u0026thinsp;4.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.65\u0026thinsp;\u0026plusmn;\u0026thinsp;3.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.91\u0026thinsp;\u0026plusmn;\u0026thinsp;5.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAMH(ng/ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.85\u0026thinsp;\u0026plusmn;\u0026thinsp;4.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.1\u0026thinsp;\u0026plusmn;\u0026thinsp;4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.7\u0026thinsp;\u0026plusmn;\u0026thinsp;4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eLH(IU/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.63\u0026thinsp;\u0026plusmn;\u0026thinsp;4.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.14\u0026thinsp;\u0026plusmn;\u0026thinsp;3.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.92\u0026thinsp;\u0026plusmn;\u0026thinsp;5.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eEstradiol(pg/mL)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61.44\u0026thinsp;\u0026plusmn;\u0026thinsp;48.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e66.97\u0026thinsp;\u0026plusmn;\u0026thinsp;47.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57.51\u0026thinsp;\u0026plusmn;\u0026thinsp;50.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eTSH(mIU/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.08\u0026thinsp;\u0026plusmn;\u0026thinsp;1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.06\u0026thinsp;\u0026plusmn;\u0026thinsp;1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.1\u0026thinsp;\u0026plusmn;\u0026thinsp;1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eprolactin(\u0026micro;g/L)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e139.77\u0026thinsp;\u0026plusmn;\u0026thinsp;212.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e163.56\u0026thinsp;\u0026plusmn;\u0026thinsp;205.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e126.56\u0026thinsp;\u0026plusmn;\u0026thinsp;218.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.58\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eprimary endometrial thickness(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.69\u0026thinsp;\u0026plusmn;\u0026thinsp;1.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.51\u0026thinsp;\u0026plusmn;\u0026thinsp;1.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u0026thinsp;\u0026plusmn;\u0026thinsp;1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003esecondary endometrial thickness(mm)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.24\u0026thinsp;\u0026plusmn;\u0026thinsp;2.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.76\u0026thinsp;\u0026plusmn;\u0026thinsp;1.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.10\u0026thinsp;\u0026plusmn;\u0026thinsp;1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e* Qualitative parameters are given as number (%) and quantitative parameters are given as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation.\u003c/p\u003e\n\u003ch3\u003eAssociation of endometrial compaction with chemical and clinical pregnancy rate\u003c/h3\u003e\n\u003cp\u003eIn this part of the study, the association between the presence or absence of endometrial compaction with the rate of chemical pregnancy and clinical pregnancy was investigated. The chemical pregnancy rate in this study was 99(39.13%), 21(35%) of fresh embryos and 78(40%) of FETs, and the clinical pregnancy rate was 71(28.06%). The results showed that both chemical and clinical pregnancy have a significant association with compact endometrium. Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the incidence rate of pregnancy in two groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of chemical and clinical pregnancy rate between compact and non-compact groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eparameter\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eCompact (N\u0026thinsp;=\u0026thinsp;93)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eno compaction (N\u0026thinsp;=\u0026thinsp;160)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eChemical pregnancy\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e51(54.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48(30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e42(45.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112(70)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003eclinical pregnancy\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePositive\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37(39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34(21.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e56(60.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e126(78.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch3\u003eAssociation of endometrial compaction percentage with chemical and clinical pregnancy\u003c/h3\u003e\n\u003cp\u003eIn this part of the study, the association of the percentage of endometrial compaction with the rate of chemical and clinical pregnancy was evaluated. Based on our analysis, all the percentages of compaction have a significant association with the occurrence of chemical and clinical pregnancy (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of chemical and clinical pregnancy rate in different percent of compaction\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eparameter\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003e\u003cem\u003eChemical pregnancy\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003e\u003cem\u003eClinical pregnancy\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003e(Chemical)\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003e(Clinical)\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003ePositive\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eNegative\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003ePositive\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eNegative\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003e5 percent compaction\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes(N\u0026thinsp;=\u0026thinsp;77)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44(44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33(21.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37(52.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40(22)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo(N\u0026thinsp;=\u0026thinsp;176)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e55(55.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e121(78.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34(47.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e142(78)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cem\u003e10 percent compaction\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes(N\u0026thinsp;=\u0026thinsp;49)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35(35.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14(9.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32(45.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17(9.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo(N\u0026thinsp;=\u0026thinsp;204)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e64(64.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e140(90.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39(54.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e165(90.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e15 percent compaction\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes(N\u0026thinsp;=\u0026thinsp;28)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23(23.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6(3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo(N\u0026thinsp;=\u0026thinsp;225)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e76(76.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e149(96.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49(69)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e176(96.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e20 percent compaction\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYes(N\u0026thinsp;=\u0026thinsp;14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13(13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(0.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13(18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003cp\u003e0.0001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo(N\u0026thinsp;=\u0026thinsp;239)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e86(86.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e153(99.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58(81.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e181(99.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eAssociation of primary and secondary endometrial thickness with chemical and clinical pregnancy and ROC curve analysis\u003c/b\u003e \u003c/p\u003e \u003cp\u003eIn this part of the study, primary and secondary endometrial thickness was compared between people with and without chemical and clinical pregnancy separately. The results showed that only secondary thickness (thickness measured on the day of embryo transfer) had a significant difference between people with positive and negative clinical pregnancies. So in people with positive clinical pregnancy, the thickness of the endometrium was less (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAlso, the predictive power of secondary endometrial thickness was evaluated in clinical pregnancy prediction. Based on this, this parameter has an acceptable power in predicting clinical pregnancy. Figure\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the area under the curve (AUC) in this regard (AUC\u0026thinsp;=\u0026thinsp;0.59, P-value\u0026thinsp;=\u0026thinsp;0.01).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eassociation of endometrial thickness with chemical and clinical thickness\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eChemical pregnancy\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eprimary endometrial thickness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive(N\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative(N\u0026thinsp;=\u0026thinsp;154)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.49\u0026thinsp;\u0026plusmn;\u0026thinsp;1.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003esecondary endometrial thickness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive(N\u0026thinsp;=\u0026thinsp;99)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.09\u0026thinsp;\u0026plusmn;\u0026thinsp;2.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative(N\u0026thinsp;=\u0026thinsp;154)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.51\u0026thinsp;\u0026plusmn;\u0026thinsp;2.35\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eClinical pregnancy\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eMean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eP-value\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eprimary endometrial thickness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive(N\u0026thinsp;=\u0026thinsp;71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.79\u0026thinsp;\u0026plusmn;\u0026thinsp;1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative(N\u0026thinsp;=\u0026thinsp;182)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.55\u0026thinsp;\u0026plusmn;\u0026thinsp;1.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003esecondary endometrial thickness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePositive(N\u0026thinsp;=\u0026thinsp;71)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.92\u0026thinsp;\u0026plusmn;\u0026thinsp;1.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e0.006\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNegative(N\u0026thinsp;=\u0026thinsp;182)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.67\u0026thinsp;\u0026plusmn;\u0026thinsp;2.33\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eToday, the thickness of the endometrium as a key factor affects the pregnancy outcomes in infertile patients. Based on this, it has been shown that endometrial compaction can affect on increasing the fertility success in patients (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn the present study, the results showed that the percentage of chemical and clinical pregnancy was higher in the compacted group compared to the non-compacted one, which was statistically significant. In terms of chemical and clinical pregnancy, 74.2% were positive in the compacted group and 60% in the non-compacted group. In addition, in terms of clinical pregnancy, 48.8% were positive in the non-compacted cases.\u003c/p\u003e \u003cp\u003eYoungster and his colleagues showed that the ratio of clinical and ongoing pregnancy was higher in the compacted group, which was consistent with the present study (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Also, Ju et al. showed that the percentage of clinical pregnancy was higher in the compacted group In this study, clinical pregnancy evaluation was done in patients undergoing frozen-thaw embryo transfer (FET) cycle (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). In another study, it was shown that live birth is directly related to endometrial compaction; so that, the incidence of live birth was higher in the compacted group.(\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDuring the menstrual cycle, in the follicular phase, the secretion of estrogen causes the growth and proliferation of endometrial cells, as well as the formation of blood vessels. Following ovulation, the secretion of progesterone stops the endometrial volume increment. However, it does not stop the thickening of the endometrium, and the growth of blood vessels continues (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Several studies have shown that pregnancy outcomes are affected by the percentage of endometrial compaction (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e). In the present study, the amount of endometrial compaction was evaluated in percentages of 5, 10, 15 and 20. The rate of pregnancy in four groups of %5, %10, %15, and %20 compaction was 77(30.4%), 49(19.4%), 28(11.1%), and 14(5.5%), respectively.\u003c/p\u003e \u003cp\u003eHaas et al. showed that with the increase of endometrial compaction from 5\u0026ndash;10%, the rate of clinical and ongoing pregnancy increased (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Youngster and his colleagues showed that the clinical and chemical pregnancy rate was higher in the compacted group with 10 and 15% compared to 5%. Further investigations showed that an increase of more than 10% compaction does not have much effect on the clinical and chemical pregnancy rate (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Their results were not consistent with the present study. Thhis inconsistency can be due to the number of patients examined and the days of measurement after embryo transfer.\u003c/p\u003e \u003cp\u003eOn the other hand, in the present study only secondary thickness has predictive value for clinical pregnancy. Meanwhile, various studies measured the thickness of the endometrium on different days after embryo transfer and reported its different effects on pregnancy outcomes. This study also had a series of limitations; one of which was not evaluating the thickness of the endometrium on different days after embryo transfer. On the other hand, more studies should be done on the bigger populations in the future.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eAccording to the main results of this study, endometrial compaction has a significant effect on the rate of chemical and clinical pregnancy. Although, in this study, all the percentages of compaction had a significant association with pregnancy, no significant superiority was observed in a particular percentage of compaction. On the other hand, the results showed that the thickness of the endometrium on the day of embryo transfer, regardless of compaction had a definite effect on pregnancy success; it is also a valuable predictive factor.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe wish thank you of all our colleague in Tehran university of medical science.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contribution\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMarzieh Aghahosseini, Ashraf Aleyassin, Sedigheh Hosseinimousa design the manuscript. Atoosa Etezadi, Ayda Najafian, and Fatemeh Sarvi write the manuscript. Maryam Shabani Nashtaee analysis data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData availability is corresponding author responsibility.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll the procedures performed in the studies involving human participants were in accordance with the ethical standards of the local ethics committee of Tehran university of medical science (IR.TUMS.SHARIATI.REC.1401.013), as well as the 1964 Helsinki declaration.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNon\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAndrus M (2020) Exhibition and film about miscarriage, infertility, and stillbirth: Art therapy implications. Art therapy 37(4):169\u0026ndash;176\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFujimoto A, Ichinose M, Harada M, Hirata T, Osuga Y, Fujii T (2014) The outcome of infertility treatment in patients undergoing assisted reproductive technology after conservative therapy for endometrial cancer. J Assist Reprod Genet 31:1189\u0026ndash;1194\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBu Z, Wang K, Dai W, Sun Y (2016) Endometrial thickness significantly affects clinical pregnancy and live birth rates in frozen-thawed embryo transfer cycles. Gynecol Endocrinol 32(7):524\u0026ndash;528\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOron G, Hiersch L, Rona S, Prag-Rosenberg R, Sapir O, Tuttnauer-Hamburger M et al (2018) Endometrial thickness of less than 7.5 mm is associated with obstetric complications in fresh IVF cycles: a retrospective cohort study. Reprod Biomed Online 37(3):341\u0026ndash;348\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShi W, Zhang S, Zhao W, Xia X, Wang M, Wang H et al (2013) Factors related to clinical pregnancy after vitrified\u0026ndash;warmed embryo transfer: a retrospective and multivariate logistic regression analysis of 2313 transfer cycles. Hum Reprod 28(7):1768\u0026ndash;1775\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKumbak B, Erden H, Tosun S, Akbas H, Ulug U, Bah\u0026ccedil;eci M (2009) Outcome of assisted reproduction treatment in patients with endometrial thickness less than 7 mm. Reprod Biomed Online 18(1):79\u0026ndash;84\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao J, Zhang Q, Wang Y, Li Y (2014) Endometrial pattern, thickness and growth in predicting pregnancy outcome following 3319 IVF cycle. Reprod Biomed Online 29(3):291\u0026ndash;298\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYuan X, Saravelos SH, Wang Q, Xu Y, Li T-C, Zhou C (2016) Endometrial thickness as a predictor of pregnancy outcomes in 10787 fresh IVF\u0026ndash;ICSI cycles. Reprod Biomed Online 33(2):197\u0026ndash;205\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGingold JA, Lee JA, Rodriguez-Purata J, Whitehouse MC, Sandler B, Grunfeld L et al (2015) Endometrial pattern, but not endometrial thickness, affects implantation rates in euploid embryo transfers. Fertil Steril 104(3):620\u0026ndash;628e5\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGardner DK (1999) In-vitro culture of human blastocysts. Towards reproductive certainty: fertility and genetics beyond 1999. :378\u0026thinsp;\u0026ndash;\u0026thinsp;88\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHeitmann RJ, Hill MJ, Richter KS, DeCherney AH, Widra EA (2013) The simplified SART embryo scoring system is highly correlated to implantation and live birth in single blastocyst transfers. J Assist Reprod Genet 30:563\u0026ndash;567\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYoungster M, Mor M, Kedem A, Gat I, Yerushalmi G, Gidoni Y et al (2022) Endometrial compaction is associated with increased clinical and ongoing pregnancy rates in unstimulated natural cycle frozen embryo transfers: a prospective cohort study. J Assist Reprod Genet 39(8):1909\u0026ndash;1916\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJu W, Wei C, Lu X, Zhao S, Song J, Wang H et al (2023) Endometrial compaction is associated with the outcome of artificial frozen-thawed embryo transfer cycles: a retrospective cohort study. J Assist Reprod Genet. :1\u0026ndash;12\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYaprak E, Ş\u0026uuml;k\u0026uuml;r YE, \u0026Ouml;zmen B, S\u0026ouml;nmezer M, Berker B, Atabekoğlu C et al (2023) Endometrial compaction is associated with the increased live birth rate in artificial frozen-thawed embryo transfer cycles. Hum Fertility 26(3):550\u0026ndash;556\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTabibzadeh S (1990) Proliferative activity of lymphoid cells in human endometrium throughout the menstrual cycle. J Clin Endocrinol Metabolism 70(2):437\u0026ndash;443\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMoreno I, Codo\u0026ntilde;er FM, Vilella F, Valbuena D, Martinez-Blanch JF, Jimenez-Almaz\u0026aacute;n J et al (2016) Evidence that the endometrial microbiota has an effect on implantation success or failure. Am J Obstet Gynecol 215(6):684\u0026ndash;703\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen X-T, Sun Z-G, Song J-Y (2023) Does endometrial compaction before embryo transfer affect pregnancy outcomes? a systematic review and meta-analysis. Front Endocrinol. ;14\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaas J, Smith R, Zilberberg E, Nayot D, Meriano J, Barzilay E et al (2019) Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers. Fertil Steril 112(3):503\u0026ndash;509e1\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Endometrial Thickness, Fertility Rate, Assisted Reproductive Technology","lastPublishedDoi":"10.21203/rs.3.rs-4009419/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4009419/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eToday, the thickness of the endometrium as a key factor plays an important role in pregnancy outcomes of infertile patients. Based on this, it has been shown that endometrial compaction affect fertility success in patients. In this study, the impact of endometrial compaction on pregnancy outcomes has been evaluated.\u003c/p\u003e\u003ch2\u003eMaterial and methods:\u003c/h2\u003e \u003cp\u003eThis prospective cohort study included 250 patients undergoing embryo transfer, who referred to the infertility center of Shariati Hospital in Tehran between 2021\u0026ndash;2022. They were examined from the point of view of the relationship between endometrial thickness changes and fertility rate in FET and Fresh cycles. After preparing the endometrium, its thickness was evaluated by ultrasound.\u003c/p\u003e\u003ch2\u003eResult:\u003c/h2\u003e \u003cp\u003eThe results showed that the percentage of chemical and clinical pregnancy in the compact group was higher compared to the non-compact one, which was statistically significant (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The rate of pregnancy in four groups of 5, 10, 15, and %20 compaction was 77(30.4%), 49(19.4%), 28(11.1%), and 14(5.5%), respectively.\u003c/p\u003e\u003ch2\u003eConclusion:\u003c/h2\u003e \u003cp\u003eFinally, endometrial compaction can be associated with an increase in chemical and clinical pregnancy rate in infertile patients. In addition, secondary thickness has predictive value for clinical pregnancy.\u003c/p\u003e","manuscriptTitle":"Investigating the effect of endometrial thickness changes and compaction on the fertility rate in patients undergoing ART: A prospective study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-03-13 17:17:52","doi":"10.21203/rs.3.rs-4009419/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b410035d-6999-4f25-8dad-c7bce0d16599","owner":[],"postedDate":"March 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-06-09T21:14:07+00:00","versionOfRecord":[],"versionCreatedAt":"2024-03-13 17:17:52","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4009419","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4009419","identity":"rs-4009419","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}