A meta-analysis of the relationship between endometrial thickness and outcome of in vitro fertilization cycles

Mazdak Momeni, MohammadH Rahbar, Ertuğ Kovanci
In: Journal of Human Reproductive Sciences · 2011 · vol. 4(3) , pp. 130 · doi:10.4103/0974-1208.92287 · PMID:22346080 · W2022877560
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This meta-analysis of 14 studies involving 4922 IVF cycles found significantly thicker endometria in pregnant women, with a mean difference under 1 mm, suggesting implantation potential is complex.

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Abstract

OBJECTIVE: The objective was to evaluate the relationship between endometrial thickness on the day of human chorionic gonadotropin administration and pregnancy outcome in in vitro fertilization cycles. DESIGN: This was a systematic review and meta-analysis. MATERIALS AND METHODS: We identified 484 articles using Cochrane library, PubMed, Web of Science, and Embase searches with various key words including endometrial thickness, pregnancy, assisted reproductive technology, endometrial pattern, and in vitro fertilization. A total of 14 studies with data on endometrial thickness and outcome were selected, representing 4922 cycles (2204 pregnant and 2718 nonpregnant). The meta-analysis with a random effects model was performed using comprehensive meta-analysis software. We calculated the standardized mean difference, odds ratio (OR), and 95% confidence intervals (CIs). RESULTS: There was a significant difference in the mean endometrial thickness between pregnant and nonpregnant groups (P<0.001), with a standardized mean difference of 0.4 mm (95% CI 0.22-0.58). The OR for pregnancy was 1.40 (95% CI 1.24-1.58). CONCLUSIONS: The mean endometrial thickness was significantly higher in pregnant women compared to nonpregnant. The mean difference between two groups was <1 mm which may not be clinically meaningful. Although there may be a relationship between endometrial thickness and pregnancy, implantation potential is probably more complex than a single ultrasound measurement can determine.

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