Association between Myometrial Thickness and Assisted Reproductive Technologies Outcomes: A Prospective Cohort Study

Document Type : Original Article

Authors

1 Department of Endocrinology and Female Infertility, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

2 Asali Charity Hospital, Lorestan University of Medical Science, Lorestan , Iran

3 Department of Biostatistics and Epidemiology, School of Health, Guilan University of Medical Sciences, Rasht, Iran

4 Department of Reproductive Imaging, Reproductive Biomedicine Research Center, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran

Abstract

Background: Myometrial thickness has been expected to be a prognosticator for lower uterine segment function. An
abnormal function of the uterine muscle layer can cause common and important reproductive problems. This study
aimed to evaluate the relationship between the baseline myometrial thickness and assisted reproductive technologies
(ART) outcomes.
Materials and Methods: In this prospective cohort study, 453 infertile women undergoing ART cycles without any
obvious uterine pathology, participated in this prospective cohort study from February 2013 to May 2015. In order to
measure the myometrial thickness in the anterior and posterior of the uterine, trans-vaginal ultrasounds were conducted on
days 2-4 of the cycle (menstrual phase) preceding ovarian stimulation and the day of human chorionic gonadotropin
(hCG) injection. We defined three groups based on the baseline myometrial thickness in the anterior and posterior, including
(A) <25 mm, (B) 25-29.9 mm and (C) ≥30 mm. Ovarian stimulation, oocyte retrieval and luteal phase support were
performed in accordance with the standard long protocol. Two weeks after embryo transfer, the patients underwent a
pregnancy test by checking their serum β-hCG levels. The primary outcome measure was the clinical pregnancy rate. Secondary
outcome measures were implantation rate, abortion rate and live birth rate.
Results: The clinical pregnancy (P=0.013) and implantation (P=0.003) rates were significantly lower in group A than
in two other groups. Although the live birth rate was lower in group A than two other groups, this decrease was not statistically
significant (P=0.058).
Conclusion: The findings may be a way for clinicians to draw focus on providing therapeutic strategies and a specific
supportive care for women with a baseline myometrial thickness <25 mm in order to improve the reproductive outcome
of in vitro fertilization/intracytoplasmic sperm injection (IVF-ICSI).

Keywords

Main Subjects

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International Journal of Fertility and Sterility
Volume 18, Issue 2
April 2024
Pages 123-127

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