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      A retrospective cross-sectional study: fresh cycle endometrial thickness is a sensitive predictor of inadequate endometrial thickness in frozen embryo transfer cycles

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          Abstract

          Background

          The purpose of this study is to assess predictors of inadequate endometrial cavity thickness (ECT), defined as < 8 mm, in frozen embryo transfer (FET) cycles.

          Methods

          This is a retrospective cross-sectional study at an academic fertility center including 274 women who underwent their first endometrial preparation with estradiol for autologous FET in our center from 2001-2009. Multivariable logistic regression was performed to determine predictors of inadequate endometrial development in FET cycles.

          Results

          Neither age nor duration of estrogen supplementation were associated with FET endometrial thickness. Lower body mass index, nulliparity, previous operative hysteroscopy and thinner fresh cycle endometrial lining were associated with inadequate endometrial thickness in FET cycles. A maximum thickness of 11.5 mm in a fresh cycle was 80% sensitive and 70% specific for inadequate frozen cycle thickness.

          Conclusions

          Previous fresh cycle endometrial cavity thickness is associated with subsequent FET cycle endometrial cavity thickness. Women with a fresh cycle thickness of 11.5 mm or less may require additional intervention to achieve adequate endometrial thickness in preparation for a frozen cycle.

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          Most cited references15

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          Cryopreservation of human embryos by vitrification or slow freezing: a systematic review and meta-analysis.

          To examine the literature systematically in order to identify prospective comparative trials answering the following question: Is vitrification of human embryos associated with a higher postthawing survival rate as compared with slow freezing? Systematic review and meta-analysis. University-based hospital. Not applicable. Vitrification versus slow freezing for cryopreservation of human embryos. Postthawing survival rate. Four eligible studies were identified, three of which were randomized controlled trials. Overall, the current review summarizes information from 8,824 cryopreserved human cleavage stage embryos/blastocysts (vitrification: n = 7,482; slow freezing: n = 1,342). Survival rate of cleavage stage embryos was significantly higher after vitrification as compared with slow freezing (odds ratio 15.57, 95% confidence interval 3.68-65.82; random effects model). Postthawing survival rate of vitrified blastocysts was significantly higher compared with that observed with slow freezing (odds ratio 2.20, 95% confidence interval 1.53-3.16; fixed effects model). Vitrification appears to be associated with a significantly higher postthawing survival rate than slow freezing. Further prospective trials are necessary to confirm the above results and, in addition, allow the evaluation of the two cryopreservation methods in terms of pregnancy achievement.
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            Endometrial growth and uterine blood flow: a pilot study for improving endometrial thickness in the patients with a thin endometrium.

            To examine whether thin endometria can be improved by increasing uterine radial artery (uRA) blood flow. A prospective observational study. University hospital and city general hospital. Sixty-one patients with a thin endometrium (endometrial thickness [EM] or=0.81). Vitamin E (600 mg/day, n = 25), l-arginine (6 g/day, n = 9), or sildenafil citrate (100 mg/day, intravaginally, n = 12) was given. EM and RA-RI were assessed by transvaginal color-pulsed Doppler ultrasound. Vitamin E improved RA-RI in 18 (72%) out of 25 patients and EM in 13 (52%) out of 25 patients. L-arginine improved RA-RI in eight (89%) out of nine patients and EM in six (67%) patients. Sildenafil citrate improved RA-RI and EM in 11 (92%) out of 12 patients. In the control group (n = 10), who received no medication to increase uRA-blood flow, only one (10%) patient improved in RA-RI and EM. The effect of vitamin E was histologically examined in the endometrium (n = 5). Vitamin E improved the glandular epithelial growth, development of blood vessels, and vascular endothelial growth factor protein expression in the endometrium. Vitamin E, l-arginine, or sildenafil citrate treatment improves RA-RI and EM and may be useful for the patients with a thin endometrium. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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              Hormonal induction of endometrial receptivity.

              To review and synthesize information from the scientific literature pertaining to the hormonal induction of endometrial receptivity before ET. Critical review of selected scientific literature, synthesis and formulation of opinion. Not applicable. Prospective recipients of oocyte donation or candidates for frozen embryo transfer. Hormonal treatment for the purpose of induction of endometrial receptivity. Successful induction of endometrial receptivity, as substantiated by live birth rates, pregnancy rates, implantation rates or by measuring putative markers of endometrial receptivity. The practice of assisted reproductive technology, particularly third-party parenting, in which the source of oocytes is separated from the endometrium, has allowed a separate assessment of embryo and endometrial development. Endometrial receptivity can be induced by exogenously administered E(2) and P in a variety of regimens. The degree of synchrony between embryo and endometrium influences the probability of embryo implantation and may be controlled by initiating P stimulation at different times relative to the stage of embryo development. Many substances have been investigated as adjuncts to E(2) and P in the induction of endometrial receptivity, but at the present time, their value is unproven. Estrogen and P are the only hormones necessary to prepare the endometrium for implantation. Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Reprod Biol Endocrinol
                Reprod. Biol. Endocrinol
                Reproductive Biology and Endocrinology : RB&E
                BioMed Central
                1477-7827
                2013
                10 May 2013
                : 11
                : 35
                Affiliations
                [1 ]Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA
                [2 ]Department of Obstetrics and Gynecology, Washington University School of Medicine, Washington, DC, USA
                Article
                1477-7827-11-35
                10.1186/1477-7827-11-35
                3656781
                23663223
                228eaef3-5445-4999-8773-80370e69e2d4
                Copyright © 2013 Jimenez et al.; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 February 2013
                : 6 May 2013
                Categories
                Research

                Human biology
                endometrial thickness,frozen embryo transfer,estrogen supplementation
                Human biology
                endometrial thickness, frozen embryo transfer, estrogen supplementation

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