Impact of elevated serum estradiol levels before progesterone administration on pregnancy outcomes in frozen-thawed embryo transfer for hormone replacement therapy.

IF 4.2 2区 医学 Q1 ENDOCRINOLOGY & METABOLISM Reproductive Biology and Endocrinology Pub Date : 2024-07-30 DOI:10.1186/s12958-024-01260-4
Jun Shuai, Qiaoli Chen, Siyan Wan, Xingyu Chen, Weiwei Liu, Hong Ye, Guoning Huang
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Abstract

Objective: The objective of this retrospective cohort study is to investigate the impact of monitoring serum estradiol (E2) levels before progesterone administration within hormone replacement therapy (HRT) on pregnancy outcomes in women undergoing frozen-thawed embryo transfer (FET).

Methods: Analyzed HRT-FET cycles conducted at a reproductive center from 2017 to 2022. Serum E2 levels were measured prior to progesterone administration. Multivariate stratified and logistic regression analyses were performed on 26,194 patients grouped according to terciles of serum E2 levels before progesterone administration.

Results: The clinical pregnancy rate (CPR) and live birth rate (LBR) exhibited a gradual decline with increasing serum E2 levels across the three E2 groups. Even after controlling for potential confounders, including female age, body mass index, infertility diagnosis, cycle category, number of embryos transferred, fertilization method, indication for infertility, and endometrial thickness, both CPR and LBR persistently showed a gradual decrease as serum E2 levels increased within the three E2 groups. The same results were obtained by multivariate logistic regression analysis.

Conclusions: This large retrospective study indicates that elevated serum E2 levels before progesterone administration during HRT-FET cycles are associated with reduced CPR and LBR post-embryo transfer. Therefore, it is advisable to monitor serum E2 levels and adjust treatment strategies accordingly to maximize patient outcomes.

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使用黄体酮前血清雌二醇水平升高对冷冻解冻胚胎移植激素替代疗法妊娠结果的影响。
研究目的本回顾性队列研究旨在探讨在激素替代疗法(HRT)中使用黄体酮之前监测血清雌二醇(E2)水平对接受冻融胚胎移植(FET)的女性妊娠结局的影响:分析2017年至2022年在生殖中心进行的HRT-FET周期。在使用黄体酮前测量血清E2水平。对26194名患者进行了多变量分层和逻辑回归分析,根据孕酮用药前血清E2水平的三等分进行分组:结果:三个 E2 组的临床妊娠率(CPR)和活产率(LBR)随着血清 E2 水平的升高而逐渐下降。即使控制了潜在的混杂因素,包括女性年龄、体重指数、不孕诊断、周期类别、胚胎移植数量、受精方法、不孕症指征和子宫内膜厚度,在三个 E2 组中,随着血清 E2 水平的增加,CPR 和 LBR 仍呈逐渐下降趋势。多变量逻辑回归分析也得出了相同的结果:这项大型回顾性研究表明,HRT-FET 周期中使用黄体酮前血清 E2 水平升高与胚胎移植后 CPR 和 LBR 降低有关。因此,建议监测血清 E2 水平并相应调整治疗策略,以最大限度地提高患者的治疗效果。
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来源期刊
Reproductive Biology and Endocrinology
Reproductive Biology and Endocrinology 医学-内分泌学与代谢
CiteScore
7.90
自引率
2.30%
发文量
161
审稿时长
4-8 weeks
期刊介绍: Reproductive Biology and Endocrinology publishes and disseminates high-quality results from excellent research in the reproductive sciences. The journal publishes on topics covering gametogenesis, fertilization, early embryonic development, embryo-uterus interaction, reproductive development, pregnancy, uterine biology, endocrinology of reproduction, control of reproduction, reproductive immunology, neuroendocrinology, and veterinary and human reproductive medicine, including all vertebrate species.
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