Farname Inc. in collaboration with Iranian Society of Gynecology Oncology


1 1 Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 University of Medical Sciences, Ahvaz, Iran


Background: Frozen embryo replacement (FER) cycle is a procedure that assists in vitro fertilization (IVF) outcome by using the storage and transfer of excess embryos. This study evaluated the success of FER using spinnbarkeit and endometrial thickness.
Materials and Methods: This cross-sectional study was performed on 97 infertile women at the Imam Khomeini hospital of Ahvaz, from March 2019 to March 2020. Endometrium was prepared with Estradiol valerate from the third day of menstruation and followed by serial vaginal ultrasound till the thickness of the endometrium attain 7 millimeter to 8 millimeter. The cervical secretions were collected from the external os and were estimated based on centimeters. Also, endometrial thickness was recorded.
Results: no substantial difference between endometrial thickness and spinnbarkeit in the FER cycles with pregnancy outcomes was observed (P>0.05).
Conclusion: Some variables such as endometrial thickness, spinnbarkiet, estradiol dose intake, and quality of embryos have no relationship with the success of FER cycles.


  1. 1. Mustafa, M., et al. (2019) Male and female infertility: causes, and management. IOSR Journal of Dental and Medical Sciences. 18: p. 27-32 2. tahmasbpour Marzouni, E., et al. (2021) Potential roles of epigenetic modifications in male reproductive development and function: a review on new approach for etiology of infertility. International Journal of Fertility and Sterility: p. - 3. Zhao, N., et al. (2020) Differentiation of Human Induced Pluripotent Stem Cells Into Male Germ Cells. Current Stem Cell Research & Therapy, 4. Wang, G. and M. Farzaneh (2020) Mini review; differentiation of human pluripotent stem cells into oocytes. Current stem cell research & therapy. 15(4): p. 301-307 5. Azizollahi, s., et al. (2021) Clinical and Molecular Effects of GnRH Agonist and Antagonist on The Cumulus Cells in The In Vitro Fertilization Cycle: A Double Blind Randomized Clinical Trial. International Journal of Fertility and Sterility. 15(3): p. 202-209 6. Sarmon, K.G., et al. (2021) Assisted reproductive technologies and the risk of stillbirth in singleton pregnancies: a systematic review and meta-analysis. Fertility and Sterility, 7. Amini, P., et al. (2021) Factors associated with in vitro fertilization live birth outcome: a comparison of different classification methods. International Journal of Fertility & Sterility. 15(2): p. 128 8. Wong, K., et al. (2021) Transfer of fresh or frozen embryos: a randomised controlled trial. Human Reproduction, 9. Lawrenz, B., et al. (2020) The ART of frozen embryo transfer: back to nature! Gynecological Endocrinology. 36(6): p. 479-483 10. Yarali, H., et al. (2016) Preparation of endometrium for frozen embryo replacement cycles: a systematic review and meta-analysis. Journal of assisted reproduction and genetics. 33(10): p. 1287-1304 11. Eftekhar, M., M. Rahsepar, and E. Rahmani (2013) Effect of Progesterone Supplementation on Natural Frozen-Thawed Embryo Transfer Cycles: A Randomized Controlled Trial. International Journal of Fertility and Sterility. 7(1): p. 13-20 12. Maybin, J.A. and H.O.D. Critchley (2015) Menstrual physiology: implications for endometrial pathology and beyond. Human reproduction update. 21(6): p. 748-761 13. Mokashi-Bhalerao, N. (2018) Molecular Mechanisms: Endometrial Receptivity and Implantation. The Infertility Manual: p. 16 14. Heger, A., M. Sator, and D. Pietrowski (2012) Endometrial Receptivity and its Predictive Value for IVF/ICSI-Outcome. Geburtshilfe und Frauenheilkunde. 72(8): p. 710-715 15. Mouanness, M., et al. (2021) Use of Intra-uterine Injection of Platelet-rich Plasma (PRP) for Endometrial Receptivity and Thickness: a Literature Review of the Mechanisms of Action. Reproductive Sciences: p. 1-12 16. Zhong, Y., et al. (2019) Acupuncture in improving endometrial receptivity: a systematic review and meta-analysis. BMC complementary and alternative medicine. 19(1): p. 61-61 17. Zhao, J., Q. Zhang, and Y. Li (2012) The effect of endometrial thickness and pattern measured by ultrasonography on pregnancy outcomes during IVF-ET cycles. Reproductive biology and endocrinology : RB&E. 10: p. 100-100 18. Mariani, L.L., et al. (2021) Endometrial thickness in the evaluation of clinical response to medical treatment for deep infiltrating endometriosis: a retrospective study. Archives of Gynecology and Obstetrics. 303(1): p. 161-168 19. Martyn, F., F. McAuliffe, and M. Wingfield (2014) The role of the cervix in fertility: is it time for a reappraisal? Human Reproduction. 29(10): p. 2092-2098 20. Nakano, F.Y., R.d.B.F. Leão, and S.C. Esteves (2015) Insights into the role of cervical mucus and vaginal pH in unexplained infertility. MedicalExpress. 2(2) 21. Tsiligianni, T., et al. (2011) Association between physical properties of cervical mucus and ovulation rate in superovulated cows. Canadian journal of veterinary research = Revue canadienne de recherche veterinaire. 75(4): p. 248-253 22. Craciunas, L., N. Tsampras, and C. Fitzgerald (2014) Cervical mucus removal before embryo transfer in women undergoing in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis of randomized controlled trials. Fertil Steril. 101(5): p. 1302-7 23. Eskandar, M.A., et al. (2007) Removal of cervical mucus prior to embryo transfer improves pregnancy rates in women undergoing assisted reproduction. Reproductive biomedicine online. 14(3): p. 308-313 24. Liao, S., et al. (2021) Analysis of endometrial thickness patterns and pregnancy outcomes considering 12,991 fresh IVF cycles. BMC Medical Informatics and Decision Making. 21(1): p. 1-13 25. Shaodi, Z., et al. (2020) Analysis of endometrial thickness threshold and optimal thickness interval in cleavage embryo hormone replacement freeze-thawed embryo transfer (HRT-FET). Gynecological Endocrinology. 36(11): p. 968-972 26. Sarvi, F., et al. (2017) Effect of Increased Endometrial Thickness and Implantation Rate by Granulocyte Colony-Stimulating Factor on Unresponsive Thin Endometrium in Fresh In Vitro Fertilization Cycles: A Randomized Clinical Trial. Obstetrics and gynecology international. 2017: p. 3596079-3596079 27. Liu, Y., Y.Y. Xiang, and C. Chan (2019) The association between endometrial thickness and pregnancy outcome in gonadotropin-stimulated intrauterine insemination cycles. Reproductive Biology and Endocrinology. 17(1): p. 1-8 28. . Rezaei Z, Adabi K, Sadjadi A. A Comparison of Endometrial Thickness and Pregnancy Outcomes in Two Methods of Intrauterine Injection and Subcutaneous Injection of GCSF in Infertile Women Candidates for IVF. J Obstet Gynecol Cancer Res. 2020; 5 (2) : 39-43 29. Baradwan, S., et al. (2018) The effect of endometrial thickness on pregnancy outcome in patients with Asherman’s syndrome post-hysteroscopic adhesiolysis. International journal of women's health. 10: p. 77 30. Kasius, A., et al. (2014) Endometrial thickness and pregnancy rates after IVF: a systematic review and meta-analysis. Hum Reprod Update. 20(4): p. 530-41 31. Ye, J., et al. (2020) Effect of Endometrial Thickness Change in Response to Progesterone Administration on Pregnancy Outcomes in Frozen-Thawed Embryo Transfer: Analysis of 4465 Cycles. Frontiers in endocrinology. 11: p. 546232-546232 32. Bilyk, O., et al. (2017) Epithelial-to-Mesenchymal Transition in the Female Reproductive Tract: From Normal Functioning to Disease Pathology. Frontiers in oncology. 7: p. 145-145 33. Haas, J., et al. (2019) Endometrial compaction (decreased thickness) in response to progesterone results in optimal pregnancy outcome in frozen-thawed embryo transfers. Fertility and sterility. 112(3): p. 503-509. e1 34. Zhang, T., et al. (2018) Endometrial thickness as a predictor of the reproductive outcomes in fresh and frozen embryo transfer cycles: A retrospective cohort study of 1512 IVF cycles with morphologically good-quality blastocyst. Medicine. 97(4