Estradiol ( E 2 ) Reduction Adversely Affect the Embryo Quality and Clinical Outcomes of In Vitro Fertilization and Embryo transfer (IVF-ET).

Autor: Cheng J; Reproductive Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China., Yang S; Reproductive Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China., Ma H; Reproductive Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China., Liang Y; Reproductive Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China., Zhao J; Reproductive Center, Department of Obstetrics and Gynecology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Jazyk: angličtina
Zdroj: Journal of healthcare engineering [J Healthc Eng] 2022 Apr 07; Vol. 2022, pp. 2473876. Date of Electronic Publication: 2022 Apr 07 (Print Publication: 2022).
DOI: 10.1155/2022/2473876
Abstrakt: Objective: The purpose of this study was to explore the influence of decreased serum estradiol ( E 2 ) levels during controlled ovarian hyperstimulation (COH) on in vitro fertilization and embryo transfer (IVF).
Methods: The clinical data of 300 IVF-ET cycles with patients were analyzed retrospectively. According to the presence of falling E 2 level during the COH, we divided all subjects into two groups: the E 2 levels fall group ( n  = 120, group A) and the control group ( n  = 180, group B). In group A, there were 57 patients with falling E 2 with drug dosage reduction. The other 63 patients experienced the decreased E 2 level spontaneously. The clinical and laboratory variables in the groups were compared. Receiver operator characteristic (ROC) curve analyses were carried out in order to evaluate the predict value of E 2 level on the day of human chorionic gonadotropin (hCG) administration on IVF outcomes.
Results: Duration and total dosage of gonadotropin (Gn) used were statistically more in group A than in group B ( P  < 0.001). The high-quality embryo rate was significantly lower in group A ( P  = 0.048). Women in group A had lower clinical pregnancy rate ( P  = 0.029), live birth rate ( P  < 0.001), ongoing pregnancy rate ( P  = 0.001), and higher early abortion rates ( P  = 0.008) than group B. Women with spontaneously falling E 2 group had a higher BMI index than those in the drug dosage reduction group ( P  = 0.001). More dosage and longer duration of Gn in spontaneously falling E 2 group than in the drug dosage reduction group ( P  < 0.01). There were no differences in clinical outcomes between the two types of E 2 decreased groups. Results from ROC showed an E 2 level <1987.5 pg/ml on the hCG day might predict early abortion in this study. The sensitivity was 58.4% and the specificity was 78.9%. In addition, an E 2 level >2020 pg/ml on the hCG day might be an index to predict live birth. The sensitivity was 57.0% and the specificity was 61.7%.
Conclusions: Reduction of E 2 during COH might adversely affect the clinical pregnancy, early abortion, and ongoing pregnancy of IVF-ET.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2022 Jing Cheng et al.)
Databáze: MEDLINE
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