1 RBMO VOLUME 00 ISSUE 0 2020
1
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University,
Montreal QC, Canada
2
MUHC Reproductive Centre, McGill University Health Centre, Montreal QC, Canada
© 2020 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
*Corresponding author. E-mail address: naama.steiner@mail.mcgill.ca (N Steiner). https://doi.org/10.1016/j.
rbmo.2020.07.007 1472-6483/© 2020 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.
Declaration: The authors report no fnancial or commercial conficts of interest.
KEYWORDS
IVF
Single embryo transfer
Uterine dimensions
ARTICLE
Effect of uterine dimensions on live birth
rates after single embryo transfer in infertile
women
BIOGRAPHY
Naama Steiner received her medical degree from the Ben-Gurion University (BGU) and
completed OB/GYN residency training at the Soroka University Medical Center, Beer-
Sheva, Israel. She is currently doing postgraduate training in reproductive endocrinology
and infertility at McGill University, Canada.
Naama Steiner
1,2,
*, Senem Ates
1
, Talya Shaulov
1
, Samer Tannus
1
,
Michael H. Dahan
1,2
KEY MESSAGE
Uterine parameters, particularly uterine length and cervical length, are statistically associated with live birth
outcomes from IVF. However, due to signifcant variability and low levels of predictability by ROC curves,
uterine parameters are not clinically useful.
ABSTRACT
Research question: Do uterine size parameters measured by baseline transvaginal ultrasound predict live birth after
single embryo transfer (SET) of a high-quality blastocyst?
Design: Retrospective cohort study including women undergoing their frst SET between August 2010 and March
2014 at a large university hospital reproductive centre. The effects of baseline uterine dimensions on live birth rates
(LBR) were analysed while controlling for confounding effects.
Results: A total of 437 nulliparous and 70 parous women were included. The nulliparous group had lower body
mass index (BMI) (24.4 ± 5.1 versus 25.9 ± 4.5 kg/m
2
; P = 0.015) and a higher number of fbroids (0.4 ± 1.0 versus
0.2 ± 0.5; P = 0.005) than the parous group. While controlling for confounding effects, none of the uterine
parameters appeared to be a signifcant predictor of LBR among nulliparous and parous women (P > 0.05 in all
cases). A subsequent analysis of endometrial length was done, whereby the endometrial lengths were divided into
quartiles (20.0–32.2 mm; 32.3–36.5 mm; 36.6–40.0 mm; 40.1–54.0 mm). After controlling for confounders, the
shortest quartile in the nulliparous group had a signifcantly lower LBR (P = 0.02) than the other groups. Receiver
operating characteristic curves suggested that endometrial cavity length and cervical length did not aid clinically.
Conclusion: Uterine parameters do not have a clinically useful impact on LBRs after SET of a blastocyst in infertile
women. The use of baseline endometrial length to predict live birth is no better than chance, while cervical length
only predicts failure to live birth.
Q1