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Predictive value of D-dimer in patients with unexplained recurrent implantation failure during freeze-thaw embryo
Xin Li1, Cheng Zeng1, Peili Wu1
1Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, P. R. China.
Background:
This study aimed to evaluate whether D-dimer can predict the clinical outcomes of patients with unexplained recurrent implantation failure (URIF) during freeze-thaw embryo transfer (FET) cycles.
Methods:
Our study was divided into two parts. The first part was a retrospective study that included 433 patients. Plasma D-dimer levels were monitored in all patients before FET, and the patients were classified into two groups according to whether they delivered at least one live infant or not. D-dimer was compared between groups, and receiver operating characteristic (ROC) curves were constructed to analyze the impact of D-dimer on live birth. The second part was a prospective study that included 113 patients who were categorized into high and low D-dimer groups based on the ROC curve analysis from the retrospective study. Clinical outcomes were compared between these two groups.
Results:
In the first part, we found that plasma D-dimer levels in patients with live birth were significantly lower than those in patients without live birth. According to the ROC curve, 0.22 mg/L was the cutoff value for D-dimer in the prediction of the live birth rate (LBR) (AUC 0.806, 95% CI: 0.763, 0.848). The second part of the study confirmed that clinical pregnancy rate (50.98% vs. 32.26%, P = .044) and LBR (41.18% vs. 22.58%, P = .033) of patients with D-dimer ≤0.22 mg/L were all significantly higher than those of patients with D-dimer > 0.22 mg/L.
Conclusions:
Our study indicates that D-dimer > 0.22 mg/L is a useful index for predicting URIF during FET cycles.
