Does endometrial compaction impact the pregnancy outcomes of ivf/icsi cycles? a systematic review and meta-analysis

To analyse if endometrial compaction impact the pregnancy outcomes of IVF/ICSI cycles. A meta-analysis were carried out to analyse the effect of endometrial compaction on ART cycle outcomes .The search strategy included online database searches up to March 2023. Fresh and frozen/thawed embryo transfer cycles and that compared the outcomes of endometrial compaction cycles versus no endometrial compaction cycles (no change/increase in endometrial thickness) were considered.The primary outcomes were the clinical pregnancy rate (CPR), miscarriage rate (MR) and ongoing pregnancy/live birth(OPR/LBR) rates. The random effects model was used to determine the odds ratio(OR). Although endometrial compaction did not significantly affect the CPR (OR: 1.08 [0.86-1.36], P=0.50) or the MR (OR: 1.07 [0.87-1.32];P=0.50), it seemed to be associated with a higher OPR/LBR (OR: 1.23 [1.01-1.51]; P=0.04). Table 1 shows the data.Tabled 1Table 1. Ongoing pregnancy/live birth rate. Odds ratio meta-analysisCompactionNoncompactionOR (95% CI)Hormonally Prepared CyclesHaas, 201945.2%23.1%2.75(1.58,4.81)Gill, 202075.9%57.6%2.31(1.40,3.91)Ye, 202042.6%42.7%1.00(1.40,3.91)Zilberberg, 202044.3%30.5%1.82(1.01,3.27)Jarrah, 202144.8%25.8%2.34(0.69,8.07)Jin, 202147.5%48.2%0.97(0.61,1.55)Kaye, 202163.2%57.7%1.25(0.43,3.91)Riestenberg, 202158.1%57.4%1.03(0.51,2.13)Yaprak, 202123.6%13.4%2.00(0.99,3.96)Olgan, 202258.1%57.8%1.01(0.44,2.40)Shah, 202243.6%48.0%0.84(0.33,2.11)Gursu, 202265.5%72.4%0.73(0.32,1.63)Subtotal (Random)46.7%(690/1477)44.8(1561/3487)1.36(1.04,1.79),P=0.02I2=64.3%Ovarian stimulation cyclesLam, 202140.6%41.9%0.95(0.55,1.63)Huang, 202127.4%28.7%0.94(0.76,1.15)Subtotal (Random)29.1%(213/731)29.7%(641/2157)0.94(0.78,1.13),P=0.51Natural CyclesJin, 202141.8%53.0%0.64(0.33,1.23)Huang, 202039.8%42.1%0.91(0.73,1.13)Youngster, 202254.5%13.2%7.92(2.22,31.62)Subtotal (Random)41.0%(202/493)42.4(1088/2565)1.38(0.54,3.49),P=0.49I2=86.3%GENERAL:COMBINED (RANDOM)40.9%(1105/2701)40.1%(3290/8209)1.23(1.01,1.51),P=0.04I2=69.2% Open table in a new tab Endometrial compaction resulted in a significantly higher ongoing pregnancy/live birth rate. However, the type of cycle/endometrial lining preparation seems to influence this result.