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

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...

Full description

Saved in:
Bibliographic Details
Main Authors: Hong Zeng, Yahan Chang, Nenghui Liu, Shuyi Li
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Pregnancy and Childbirth
Subjects:
Online Access:https://doi.org/10.1186/s12884-024-07072-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850100472814239744
author Hong Zeng
Yahan Chang
Nenghui Liu
Shuyi Li
author_facet Hong Zeng
Yahan Chang
Nenghui Liu
Shuyi Li
author_sort Hong Zeng
collection DOAJ
description 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.
format Article
id doaj-art-8487952072ff4130b974e740ec1742ea
institution DOAJ
issn 1471-2393
language English
publishDate 2024-12-01
publisher BMC
record_format Article
series BMC Pregnancy and Childbirth
spelling doaj-art-8487952072ff4130b974e740ec1742ea2025-08-20T02:40:18ZengBMCBMC Pregnancy and Childbirth1471-23932024-12-012411910.1186/s12884-024-07072-zEctopic pregnancy is associated with increased risk of displaced implantation window: a retrospective studyHong Zeng0Yahan Chang1Nenghui Liu2Shuyi Li3Department of Reproductive Medicine Center, Xiangya Hospital, Central South UniversityDepartment of Reproductive Medicine Center, Xiangya Hospital, Central South UniversityDepartment of Reproductive Medicine Center, Xiangya Hospital, Central South UniversityDepartment of Reproductive Medicine Center, Xiangya Hospital, Central South UniversityAbstract 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.https://doi.org/10.1186/s12884-024-07072-zAssisted reproductive medicineEctopic pregnancyEndometrial receptivity testGeneralized estimation equationWindow of implantation
spellingShingle Hong Zeng
Yahan Chang
Nenghui Liu
Shuyi Li
Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study
BMC Pregnancy and Childbirth
Assisted reproductive medicine
Ectopic pregnancy
Endometrial receptivity test
Generalized estimation equation
Window of implantation
title Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study
title_full Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study
title_fullStr Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study
title_full_unstemmed Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study
title_short Ectopic pregnancy is associated with increased risk of displaced implantation window: a retrospective study
title_sort ectopic pregnancy is associated with increased risk of displaced implantation window a retrospective study
topic Assisted reproductive medicine
Ectopic pregnancy
Endometrial receptivity test
Generalized estimation equation
Window of implantation
url https://doi.org/10.1186/s12884-024-07072-z
work_keys_str_mv AT hongzeng ectopicpregnancyisassociatedwithincreasedriskofdisplacedimplantationwindowaretrospectivestudy
AT yahanchang ectopicpregnancyisassociatedwithincreasedriskofdisplacedimplantationwindowaretrospectivestudy
AT nenghuiliu ectopicpregnancyisassociatedwithincreasedriskofdisplacedimplantationwindowaretrospectivestudy
AT shuyili ectopicpregnancyisassociatedwithincreasedriskofdisplacedimplantationwindowaretrospectivestudy