Endometrial Receptivity in IVF Cycles: Adjuvant Therapy and Success Rates

A 2006 study in Reproductive BioMedicine Online found that adjuvant therapies like low-dose aspirin or vaginal estradiol improved IVF pregnancy rates in patients with endometrial thickness under 8mm, despite no measurable increase in endometrial width.

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Key Takeaways

Adjuvant Therapy Improves IVF Success Despite No Change in Endometrial Thickness

Patients with initially thin endometrial linings (under 8mm) showed significantly higher pregnancy rates with adjuvant therapies (aspirin, estradiol, sildenafil) even though endometrial width measurements didn’t improve between mock and donor cycles.

Donor Oocyte Model Reveals Critical Endometrial Receptivity Threshold

33.8% of donor oocyte patients had endometrial widths below 8mm during mock cycles, establishing a baseline for identifying patients most likely to benefit from adjuvant therapy interventions.

Low-Dose Aspirin Shows Strongest Evidence for Endometrial Receptivity Support

81mg aspirin was the most frequently tested therapy (80/123 patients) and aligned with previous research suggesting antiplatelet therapy improves blood flow to the endometrium.

Regression to the Mean Observed in Endometrial Thickness Measurements

Endometrial thickness naturally fluctuated between cycles with or without therapy, demonstrating the importance of evaluating functional outcomes rather than static measurements.

Personalized Adjuvant Therapy Selection Remains an Unanswered Clinical Challenge

While 123 patients showed improved outcomes with adjuvant therapy compared to 380 without, the optimal treatment (aspirin, vaginal estradiol, or sildenafil) for specific patient profiles is still undetermined.

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