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Abstract(s)
A recetividade endometrial traduz-se na capacidade do endométrio providenciar um meio adequado para o desenvolvimento do embrião, sendo um fator fundamental para o estabelecimento da gravidez. Por essa razão, têm sido investigados vários marcadores da mesma com o objetivo de encontrar aquele que forneça melhor informação prognóstica sobre os desfechos reprodutivos durante um ciclo de tratamento de Procriação Medicamente Assistida (PMA). A espessura endometrial tem sido o marcador mais aceite para a avaliação da recetividade endometrial e sugere que um endométrio fino está associado a piores taxas de sucesso da fertilização in vitro (FIV). Contudo, existe ainda alguma controvérsia sobre o seu valor preditivo, devido aos resultados contraditórios dos vários estudos realizados até então. Assim, o objetivo deste estudo consiste na avaliação do valor preditivo da espessura endometrial para a ocorrência do nascimento de um recém-nascido vivo no modelo da ovodoação, em que a mulher recetora não é submetida a estimulação ovárica e onde o viés da competência embrionária é minimizado. Desenhou-se um estudo multicentro retrospetivo, no qual foram analisados ciclos de transferência de embriões resultantes de FIV com oócitos doados realizados entre 1 de Janeiro de 2010 a 31 de Dezembro de 2019. A espessura endometrial, medida por ecografia ginecológica transvaginal, foi analisada quer de forma categórica, quer como uma variável contínua com recurso a polinómios fracionados. O desfecho reprodutivo primário consistiu na ocorrência do nascimento de um recém-nascido vivo. Observou-se o aumento da taxa de nados-vivos com o aumento da espessura endometrial, o que demonstra o seu valor preditivo para o nascimento de um recémnascido vivo.
Endometrial receptivity is defined by the ability of the endometrium to provide an adequate environment for embryo development, being a fundamental factor for the establishment of a pregnancy. For this reason, several markers have been investigated to find the one which may deliver the best prognostic information regarding the reproductive outcomes during Assisted Reproduction Technology (ART) treatment. Endometrial thickness has been, thus far, the most accepted marker for the assessment of endometrial receptivity and it has been suggested that a thin endometrium may be associated with worse success rates following in vitro fertilization (IVF). However, there is still some controversy regarding its predictive value, due to the contradictory results of the various studies available so far. Thus, this study aims to evaluate the predictive value of endometrial thickness for the occurrence of live birth in the oocyte donation model, in which the recipient woman is not exposed to ovarian stimulation and where any bias due to limited embryo competence is minimized. A retrospective multicenter study was designed to analyze a sample of embryo transfer resulting from IVF using donated oocytes, between January 1, 2010, and December 31, 2019. Endometrial thickness, measured by transvaginal ultrasound, was analyzed both categorically and as a continuous variable using fractional polynomials. The primary reproductive outcome was the occurrence of a live birth. An increase in live birth rates with the increase in endometrial thickness was observed, which demonstrates its predictive value for the birth of a live newborn.
Endometrial receptivity is defined by the ability of the endometrium to provide an adequate environment for embryo development, being a fundamental factor for the establishment of a pregnancy. For this reason, several markers have been investigated to find the one which may deliver the best prognostic information regarding the reproductive outcomes during Assisted Reproduction Technology (ART) treatment. Endometrial thickness has been, thus far, the most accepted marker for the assessment of endometrial receptivity and it has been suggested that a thin endometrium may be associated with worse success rates following in vitro fertilization (IVF). However, there is still some controversy regarding its predictive value, due to the contradictory results of the various studies available so far. Thus, this study aims to evaluate the predictive value of endometrial thickness for the occurrence of live birth in the oocyte donation model, in which the recipient woman is not exposed to ovarian stimulation and where any bias due to limited embryo competence is minimized. A retrospective multicenter study was designed to analyze a sample of embryo transfer resulting from IVF using donated oocytes, between January 1, 2010, and December 31, 2019. Endometrial thickness, measured by transvaginal ultrasound, was analyzed both categorically and as a continuous variable using fractional polynomials. The primary reproductive outcome was the occurrence of a live birth. An increase in live birth rates with the increase in endometrial thickness was observed, which demonstrates its predictive value for the birth of a live newborn.
Description
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Keywords
Espessura endometrial Recetividade endometrial Fertilização in vitro Ovodoação Desfechos procriação medicamente assistida Obstetrícia