Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study.

IF 2.8 2区医学 Q1 OBSTETRICS & GYNECOLOGY

BMC Pregnancy and Childbirth Pub Date : 2024-12-20 DOI:10.1186/s12884-024-07072-z

Hong Zeng, Yahan Chang, Nenghui Liu, Shuyi Li

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引用次数: 0

Abstract

Background: To evaluate the risk factors associated with WOI (window of implantation) displacement based on ERT (endometrial receptivity test), and to confirm the association of ectopic pregnancy with WOI displacement.

Methods: This is a retrospective study at the Reproductive Medicine Center of Xiangya Hospital from January 2020 to April 2024, consisting of 934 patients who performed ERT. The patients underwent 3771 assisted reproductive technology (ART) cycles and 2629 embryo transfer (ET) cycles, with each patient experiencing at least one implantation failure. The study utilized generalized estimation equation (GEE) models to examine factors associated with WOI displacement, adjusting for confounding factors like age, body mass index (BMI), and infertility type. Non-linear relationships between age or BMI with WOI displacement were explored using generalized additive models (GAM) with thresholds detected by segmented regression.

Results: Among the patients, 60.17% were in the receptive phase, 39.40% in the pre-receptive phase, and 0.43% in the post-receptive phase. Ectopic pregnancy history increased the risk of WOI displacement by 62% (aOR 1.62, 95%CI 1.03-2.53, P = 0.035), patients over 35 years old had a 50% higher risk of WOI displacement compared to patients under 34 (aOR 1.50, 95% CI 1.12-2.00, P = 0.007). Secondary infertility showed a 26% lower risk of WOI displacement than primary infertility without statistical significance (aOR 0.74 95% CI 0.54-1.02, P = 0.062). BMI ≥ 22 kg/m2 was associated with a 25% increased risk of WOI displacement without statistical significance (aOR 1.25, 95% CI 0.94-1.67, P = 0.12).

Conclusion: Ectopic pregnancy and advanced age (≥ 35) are significantly associated with increased risk of WOI displacement. Primary infertility and higher BMI (≥ 22 kg/m²) tend to increase the risk of WOI displacement though without statistical significance.

Clinical trial number: Not applicable.

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异位妊娠与植入窗口移位风险增加相关：一项回顾性研究。

背景：基于ERT（子宫内膜容受性试验）评价WOI（着床窗）移位的相关危险因素，确认异位妊娠与WOI移位的相关性。方法：回顾性研究湘雅医院生殖医学中心2020年1月至2024年4月934例ERT患者。这些患者经历了3771个辅助生殖技术（ART）周期和2629个胚胎移植（ET）周期，每个患者至少经历一次植入失败。该研究利用广义估计方程（GEE）模型来检查与子宫内膜移位相关的因素，并对年龄、体重指数（BMI）和不孕类型等混杂因素进行了调整。使用广义加性模型（GAM）探讨年龄或BMI与WOI位移之间的非线性关系，并通过分段回归检测阈值。结果：60.17%的患者处于接受期，39.40%的患者处于接受期前，0.43%的患者处于接受期后。异位妊娠史使WOI移位的风险增加62% (aOR 1.62, 95%CI 1.03-2.53, P = 0.035)， 35岁以上患者WOI移位的风险比34岁以下患者高50% （aOR 1.50, 95%CI 1.12-2.00, P = 0.007）。继发性不孕症WOI移位的风险比原发性不孕症低26%，但无统计学意义（aOR 0.74 95% CI 0.54 ~ 1.02, P = 0.062）。BMI≥22 kg/m2与WOI移位风险增加25%相关，但无统计学意义（aOR 1.25, 95% CI 0.94-1.67, P = 0.12）。结论：异位妊娠和高龄（≥35岁）与WOI移位风险增加显著相关。原发性不孕和较高的BMI（≥22 kg/m2）倾向于增加WOI移位的风险，但无统计学意义。临床试验号：不适用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Pregnancy and Childbirth OBSTETRICS & GYNECOLOGY-

CiteScore

4.90

自引率

6.50%

发文量

845

审稿时长

3-8 weeks

期刊介绍： BMC Pregnancy & Childbirth is an open access, peer-reviewed journal that considers articles on all aspects of pregnancy and childbirth. The journal welcomes submissions on the biomedical aspects of pregnancy, breastfeeding, labor, maternal health, maternity care, trends and sociological aspects of pregnancy and childbirth.