THICKENING OF THE JUNCTIONAL ZONE (EXCEEDING 10MM) IS AN INDEPENDENT RISK FACTOR FOR DECREASED IMPLATATION RATES

THICKENING OF THE JUNCTIONAL ZONE (EXCEEDING 10MM) IS AN INDEPENDENT RISK FACTOR FOR DECREASED IMPLATATION RATES

Surcel M.1 , Micu R.1 , AxenteD.2 , Nemeti Georgiana1 , Zlătescu Cristina1 , Gârlovanu Marinela1 , Surd Stela 1 , Caracostea Gabriela1

1 Obstetrics- Gynecology 1 Clinic, Cluj –Napoca, Romania
2 Surgery V Clinic „ Clujana”, Cluj- Napoca, Romania

 

Abstract

Introduction: The junctional zone is a distinct entity with a significant role in the implantation process. The aim of this study is to evaluate the impact of junctional zone thickening on the process of implantation in patients undergoing in vitro fertilization (IVF) procedures.

Material and method: Patients undergoing IVF protocoles were divided into three subgroups according to the thickness of the junctional zone (JZ): group A (JZ<6mm), group B(JZ 7-9mm), group C (JZ > 10mm). The main parameters noted were implantation rates, pregancy rates and abortion rates.

Results: The study group included 88 patients, 38 patients in group A, 32 patients in group B and 18 patients in group C. Pregnancy rates were 47,2% (group A), 40,6 % (group B) and 16,6% (group C) (p- 0,02, comparison between groups A and C) and implantation rates were 30,3% (group A), 27,2 % (gruop B) and 12,5% (group C) (p- 0,01, comparison between groups A and C).

Conclusion: Patients with JZ thickness over 10mm have a poor prognosis of implantation. Patients with JZ thickness ranging 7-9mm treated in the long protocole with gonadotropin releasing hormones (GnRH) agonists presented similar pregnancy rates with the general population.

 

Rezumat: Îngroşarea zonei joncţionale (peste 10 mm) este un factor de risc independent pentru ratele scăzute de implantare

Introducere: Zona de joncţiune este o entitate distinctă cu un puternic rol in procesul implantării Scopul studiului este de a evalua impactul îngroşării zonei de joncţiune asupra procesului de implantare la paciente aflate în proceduri de fertilizare in vitro (IVF).

Material si metoda: Pacientele aflate in protocol IVF au fost divizate în trei grupe in funcţie de grosimea zonei de joncţiune (ZJ): Grup A (ZJ < 6mm) , Grup B (ZJ 7-9mm), Grup C (ZJ > 10mm). Parametrii principali urmăriţi au fost: rata de implantare, rata de sarcini si rata de avort.

Rezultate: Lotul studiat a cuprins 88 de paciente: 38 grup A, 32 grup B si 18 grup C. Rata de sarcini a fost 47,2% (grup A ) , 40,6 % (grup B) si 16,6% (grup C) (p- 0,02 comparaţie grup A si
grup C), iar rata de implantare a fost 30,3% (grup A ) , 27,2 % (grup B) şi 12,5% (grup C) (p- 0,01 comparaţie grup A si grup C)

Concluzie: Pacientele cu dimensiuni ale ZJ peste 10 mm au un prognostic slab de implantare. În schimb pacientele cu zona de joncţiune cu dimensiuni 7-9 mm aflate sub protocol cu AgGnRh au prezentat rate de sarcina similare populaţiei generale.

Cuvinte cheie: FIV, zonă joncţională, implantare

 

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