Editor's Choice

Professor Hans Evers, Editor-in-Chief of Human Reproduction, casts his eye over the current issue of Human Reproduction and selects his own highlight.

Editor's comment

More than 1200 embryo transfers with an endometrial thickness below 7mm

And here it finally is, the much anticipated ESTEEMThe impact of a thin endometrium has been a longstanding topic of lively debate among IVF clinicians. Kimberly Liu et al., from Toronto, Canada, now have reviewed over 40,000 fresh and frozen IVF cycles. They show that live birth rates decreased and pregnancy loss rates increased with each millimeter decline of endometrial thickness below 8 mm in fresh transfer cycles. In frozen transfer cycles, live birth rates decreased below 7mm, but no significant difference in pregnancy loss rates was found. The likelihood of achieving an endometrial thickness over 8 mm decreased with age. Yet, live birth rates remained fair (15-21%) in patients with an endometrial thickness of 5-6 mm in fresh and 4-6 mm in frozen cycles. Data were ‘suppressed and not available’ for 49 embryo transfers in women with an endometrium below 4 mm.
trial. After all the usual wear and tear (and more) of doing a randomized clinical trial (RCT) at 9 sites in 7 countries, lagging recruitment, power failure, increased costs, attrition, protocol violations, drop-outs, lost to follow-up, the trial landed on our pages. It illustrates why people are reluctant to do RCTs. They last long, cost much and produce results when the ART field has hurried ahead already to new sensational developments. But we need them, someone has to do the leg work. Joep Geraedts, Karen Sermon, Willem Verpoest and their 29 collaborators in ESTEEM provide the evidence that preimplantation genetic testing for aneuploidy (by comprehensive chromosome screening of the first and second polar body to select euploid embryos for transfer) does not substantially increase the live birth rate following ICSI in women aged 36 to 40 years.

Read the study

 

Reference

K E Liu M Hartman A Hartman Z -C Luo N Mahutte

The impact of a thin endometrial lining on fresh and frozen–thaw IVF outcomes: an analysis of over 40 000 embryo transfers

Human Reprod volume 33, issue 10, 1 October 2018 pages 1883-1888