Ali OVAYOLU, İsmet GÜN, Dilek BENK ŞİLFELER, Tayfun KUTLU

Açıklanamayan infertilide endometriyal kalınlık ve canlı doğum

Amaç: Açıklanmayan infertilide human koryonik gonadotropin (hCG) günü ölçülen endometriyal kalınlık ile canlı doğum oranları arasında ilişki olup, olmadığını araştırmaktır.Gereç ve Yöntemler: Bu araştırma 2005-2013 yılları arasında Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma hastanesinde tüp bebek tedavisi uygulanmış hastalarda yapılan retrospektif bir çalışmadır. Çalışmaya 23-39 yaş aralığında, vücut kitle indeksi 30 kg/m2 altında olan ve embriyoda herhangi bir işlemin yapılmadığı ve taze embriyo transferi yapılmış kadınlar dahil edildi. Hastalar canlı doğum yapıp (grup 1), yapmamalarına (grup 2) göre 2 gruba ayrıldı. hCG günü 2-boyutlu ultrason ile midsagittal planda ölçülen endometriyal doku kalınlığı, siklus tedavi karakterleri ve hastaya ait demografik karakterler gruplar arasında karşılaştırıldı. Ayrıca hCG günü ölçülen endometriyal doku kalınlığına göre; 7 mm ve altı, 8 mm, 9 mm, 10 mm, 11 mm, 12 mm, 13 mm ve 14 mm ve üstü olan subgruplar oluşturuldu. Bu subgruplar arasında canlı doğum yüzdeleri açısından karşılaştırmalar yapıldı. İstatistiksel karşılaştırmada devamlı veriler için student t-testi ve kategorik değerler için ki-kare testi kullanıldı.Bulgular: Çalışmaya 359 hasta dahil edildi, 104 hasta grup 1 ve 255 hasta grup 2. Gruplar arasında hCG günü ölçülen estradiol seviyeleri (pg/ml) dışında fark yoktu (2517.2±1106.0 ve 2210.8±991.7, sırasıyla; p=0.011). Her bir endometriyal doku kalınlığından oluşturulan subgruplar arasında en yüksek canlı doğum oranı 13 mm de %36.8 iken, en düşük canlı doğum oranı 12 mm de %23.9 idi. Fakat subgruplar arasında canlı doğum oranları açısından istatistiksel olarak bir fark bulunamadı. Sonuç: Açıklanamayan infertilitede canlı doğum oranları hCG günü ölçülen endometriyal doku kalınlığından bağımsızdır.

Anahtar Kelimeler:

açıklanamayan infertilite; tüp bebek; endometriyal kalınlık; canlı doğum oranı

Live Birth and Endometrial Thickness in Unexplained Infertility

Objective: We aimed to demonstrate any possible relationship between endometrial thickness on the day of hCG trigger and live birth rates (LBRs) among women with unexplained infertility who underwent IVF/ICSI-ET cycles. Materials and Methods: We retrospectively collected data from Zeynep Kamil Women's and Children's Disease Training and Research Hospital, IVF Center archive. Cases between 2005 and 2013 were collected. Women aged between 23-39 years with a BMI <30 kg/m2 with fresh embryo transfers were included. Patients were divided into two groups based on their livebirth status (live birth: group 1, no live birth: group 2). Demographic characteristics, treatment regimens, and endometrial thickness on the day of hCG trigger were compared between the two groups. In addition, patients were divided into subgroups according to the endometrial thickness on the day of hCG trigger (≤7 mm, 8 mm, 9 mm, 10 mm, 11 mm, 12 mm, 13 mm, and ≥14 mm, respectively). LBRs were compared between these subgroups. Results: Three hundred fifty-nine cycles (group 1: n=104, group 2: n=255) were included for statistical analysis. Other than estradiol level (pg/mL) on the day of hCG trigger (2517.2±1106.0, 2210.8±991.7, respectively; p=0.011), there were no statistically significant differences between the two groups. Among the subgroups based on endometrial thickness, the highest LBR was detected in the 13 mm subgroup (36.8%) and lowest LBR was detected in 12 mm subgroup (23.9%). However, LBRs were not statistically significant between the subgroups. Conclusion: LBRs do not seem to be affected by endometrial thickness on the day of hCG trigger among couples with unexplained infertility.

Keywords:

unexplained infertility; in-vitro fertilization; endometrial thickness; live birth pregnancy rate,

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