The association between endometrial thickness and ectopic pregnancy among women who underwent in vitro fertilization, systematic review and meta-analysis.

BACKGROUND

Many women are turning to in vitro fertilization to address infertility. Experts are striving to reduce complications such as ectopic pregnancy and improve the chances of successful pregnancy. Endometrial thickness is used as a factor to predict complications. We aim to systematically review articles to investigate the association between endometrial thickness and ectopic pregnancy in women undergoing in vitro fertilization.

METHODS

Studies evaluating the relationship between endometrial thickness and ectopic pregnancy rates in individuals after in vitro fertilization were found on PubMed, Embase, Scopus, and Web of Science. Pooled odds ratios with 95% confidence intervals were utilized.

RESULTS

Out of 605 articles, 20 were included in the systematic review, and seven met the criteria for the meta-analysis. The combined analysis revealed a statistically significant correlation between endometrial thickness and the likelihood of ectopic pregnancy (combined odds ratio: 0.81, 95% CI: 0.78-0.85; I2=0.01%; p < 0.001).

CONCLUSION

Thinner endometrial thickness is associated with an increased risk of ectopic pregnancy in IVF; however, this finding should be interpreted cautiously due to the observational design, potential confounding, and publication bias. Clinically, this may aid in risk stratification but should not be used alone, and further prospective studies are needed to confirm its independent predictive value.