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Background <p>This study aimed to explore whether an endometrial thickness (EMT) cutoff of 7 mm or 8 mm was more appropriate to define thin endometrium (TE) from the perspective of miscarriage and obstetric-neonatal complications.</p> Methods <p>We conducted a retrospective cohort study of 15,979 patients who had a positive serum β-human chorionic gonadotropin test after undergoing their first frozen-thaw embryo transfer. The main outcomes were early pregnancy loss, late pregnancy loss, and the rates of obstetric and neonatal complications.</p> Results <p>When TE was defined by EMT &lt;8 mm, the TE group exhibited a similar risk of early miscarriage (17.2% versus 15.7%, P=0.086) to the control group (EMT ≥8 mm). However, the TE group defined by EMT &lt;7 mm had significantly higher rates of early miscarriage (21.5% versus 15.6%, P&lt;0.001) than the control group (EMT ≥7 mm). The conclusion remained consistent after adjustment for age and other confounders in logistic regression. In addition, the adjusted odds ratio (aOR) for preterm birth increased from 1.281 (95% CI: 1.022-1.606) at an EMT &lt;8 mm to 2.050 (95% CI: 1.427-2.945) at an EMT &lt;7 mm, and the aOR for low birth weight increased from 1.394 (95% CI: 1.041-1.867) at an EMT &lt;8 mm to 2.488 (95% CI: 1.611-3.843) at an EMT &lt;7 mm.</p> Conclusions <p>When thin endometrium was defined as EMT &lt;7 mm, the TE group had significantly higher risks of early miscarriage, preterm birth, and low birth weight than when thin endometrium was defined as EMT &lt;8 mm. Because dilation and curettage after miscarriage may further damage the endometrium in patients with thin endometrium, pregnancy loss should be considered when debating the definition of thin endometrium.</p>

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Definition of thin endometrium from the perspective of miscarriage following frozen embryo transfer: a retrospective cohort study of 15,979 pregnancies

  • 期刊论文

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  • 发表日期：

    2026年7月20日

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  • Liu Jiang,
  • Haoming Huang,
  • Yueping Zhou,
  • Yuchen Gong,
  • Xiujuan Tan,
  • Kun Qian

摘要

Background

This study aimed to explore whether an endometrial thickness (EMT) cutoff of 7 mm or 8 mm was more appropriate to define thin endometrium (TE) from the perspective of miscarriage and obstetric-neonatal complications.

Methods

We conducted a retrospective cohort study of 15,979 patients who had a positive serum β-human chorionic gonadotropin test after undergoing their first frozen-thaw embryo transfer. The main outcomes were early pregnancy loss, late pregnancy loss, and the rates of obstetric and neonatal complications.

Results

When TE was defined by EMT <8 mm, the TE group exhibited a similar risk of early miscarriage (17.2% versus 15.7%, P=0.086) to the control group (EMT ≥8 mm). However, the TE group defined by EMT <7 mm had significantly higher rates of early miscarriage (21.5% versus 15.6%, P<0.001) than the control group (EMT ≥7 mm). The conclusion remained consistent after adjustment for age and other confounders in logistic regression. In addition, the adjusted odds ratio (aOR) for preterm birth increased from 1.281 (95% CI: 1.022-1.606) at an EMT <8 mm to 2.050 (95% CI: 1.427-2.945) at an EMT <7 mm, and the aOR for low birth weight increased from 1.394 (95% CI: 1.041-1.867) at an EMT <8 mm to 2.488 (95% CI: 1.611-3.843) at an EMT <7 mm.

Conclusions

When thin endometrium was defined as EMT <7 mm, the TE group had significantly higher risks of early miscarriage, preterm birth, and low birth weight than when thin endometrium was defined as EMT <8 mm. Because dilation and curettage after miscarriage may further damage the endometrium in patients with thin endometrium, pregnancy loss should be considered when debating the definition of thin endometrium.