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目的:探讨不同体质量指数（body mass index，BMI）人群中转化日子宫内膜厚度（endometrial thickness，EMT）对激素替代治疗-冻融胚胎移植（hormone replacement frozen-thawed embryo transfer，HRT-FET）临床结局的影响，并分析达到理想临床妊娠率时对应的最佳EMT和EMT区间。方法:回顾性队列研究分析2013年1月至2017年12月期间在河南省人民医院生殖医学中心行激素替代周期HRT-FET准备子宫内膜的10 239个周期，根据BMI分为低体质量组（BMI<18.5 kg/mn 2）、正常体质量组（BMI=18.5~24.9 kg/㎡）、超重组（BMI=25.0~29.9 kg/mn 2）和肥胖组（BMI≥30.0 kg/mn 2），每组再根据EMT分为4个亚组：EMT<8.0 mm、8.0 mm≤EMT<10.0 mm、10.0 mm≤EMT0.05）；正常体质量组及超重组各亚组间，随着EMT的增加临床妊娠率及活产率均增加明显（正常体质量组各亚组均n P<0.001，超重组各亚组n P=0.123、n P=0.009、n P=0.016；均n P<0.001）；肥胖组各亚组间随EMT增加，临床妊娠率增加不明显（n P=0.449，n P=0.279），当EMT≥12.0 mm时，增加明显（n P=0.021），活产率增加明显，差异有统计学意义（n P=0.014，n P=0.005，n P<0.001）。②曲线拟合结果显示，正常体质量组及超重组EMT对临床妊娠率及活产率的影响均呈曲线关系，即随EMT增加，临床妊娠率先明显上升，后增速变缓并高水平维持，再有下降趋势；低体质量组及肥胖组EMT对临床妊娠率及活产率的影响呈直线关系。③根据曲线拟合，正常体质量组及超重组进行阈值效应分析，正常体质量组EMT对临床妊娠率及活产率影响的内膜拐点为10.0 mm，EMT低于10.0 mm时，其每增加1.0 mm，临床妊娠率提高20%（n OR=1.20，95% n CI=1.13~1.26），活产率提高19%（n OR=1.19，95% n CI=1.13~1.26）；超重组EMT对临床妊娠率及活产率的拐点也为10.0 mm，低于10.0 mm时，其每增加1.0 mm，临床妊娠率提高24%（n OR=1.24，95% n CI=1.13~1.26），活产率提高26%（n OR=1.26，95% n CI=1.14~1.40）。EMT超过拐点时，随EMT增加临床妊娠率及活产率增幅不明显。n 结论:正常体质量组及超重组EMT分别在10.0~13.5/10.0~12.7 mm、10.0~14.0/10.0~12.5 mm区间时临床妊娠率及活产率最佳，子宫内膜过薄或者过厚均影响临床妊娠结局。低体质量组及肥胖组EMT对临床妊娠率及活产率影响呈直线关系，但有待进一步研究。“,”Objective:To investigate the effect of endometrial thickness (EMT) on the clinical outcome of hormone replacement frozen-thawed embryo transfer (HRT-FET) cycle in different body mass index (BMI) groups, and to analyze the threshold and optimal EMT and EMT interval corresponding to the ideal clinical pregnancy rate.Methods:A retrospective cohort study was conducted on 10 239 HRT-FET cycles in the Reproductive Medicine Center of Henan Provincial People\'s Hospital from January 2013 to December 2017, and they were divided into low weight group (BMI<18.5 kg/mn 2), normal weight group (BMI=18.5-24.9 kg/mn 2), overweight group (BMI=25.0-29.9 kg/mn 2) and obese group (BMI≥30.0 kg/mn 2). Four subgroups were divided according to EMT, respectively EMT<8.0 mm, 8.0 mm≤EMT<10.0 mm, 10.0 mm≤EMT0.05). The clinical pregnancy rate and the live birth rate increased with the increase of EMT between subgroups of normal body weight group and super-recombinant subgroups (alln P<0.001 for normal body weight subgroups,n P=0.123, n P=0.009, n P=0.016 and all n P<0.001 for super-recombinant subgroups). In the obesity group, with the increase of EMT, the clinical pregnancy rate did not increase significantly except EMT≥12.0 mm subgroup (n P=0.449, n P=0.279, n P=0.021), while the live birth rate increased significantly (n P=0.014, n P=0.005, n P<0.001). 2) Curve fitting showed that in the population of low weight and obese, influence of EMT on clinical pregnancy rate was a straight line, in the population of normal weight and overweight, influence of EMT on clinical pregnancy rate was a curve, as EMT increased the clinical pregnancy rate raised and then decreased, the impact on the live birth rate appeared similar. 3) According to the curve fitting, the threshold effect analysis of the normal weight group showed that the endometrial inflection point of EMT on the clinical pregnancy rate and the live birth rate was 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 20% and 19% for every 1.0 mm increase in endometrial thickness (n OR=1.20, 95% n CI=1.13-1.26; n OR=1.13,95% n CI=1.13-1.26). In overweight group, the inflection point of EMT on the clinical pregnancy rate and the live birth rate was also 10.0 mm. When EMT was lower than 10.0 mm, the clinical pregnancy rate and the live birth rate increased by 24% and 26% for every 1.0 mm increase in EMT (n OR=1.24, 95% n CI=1.13-1.26; n OR=1.26, 95% n CI=1.14-1.40). When EMT exceeded 10.0 mm, the clinical pregnancy rate and the live birth rate did not increase significantly with the increase of EMT.n Conclusion:In HRT-FET cycle, the endometrial thickness has an effect on the clinical pregnancy rate and the live birth rate in the normal weight group and the overweight group. The clinical pregnancy rate and the live birth rate were the best when the EMT was between 10.0-13.5/10.0-12.7 mm and 10.0-14.0/10.0-12.5 mm, respectively. Whether the endometrium was too thin or too thick would affect the clinical pregnancy outcome. The influence of EMT on clinical pregnancy rate and live birth rate was linear between the low weight group and the obese group, but further study is needed.