Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles
Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles
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DOI：
10.1007/s10815-015-0434-1
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发表时间：
2015-04-01
影响因子：
3.1
通讯作者：
Rosenwaks, Zev
中科院分区：
文献类型：
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作者：
Pereira, Nigel;Reichman, David E.;Rosenwaks, Zev
探讨hCG触发当天血清雌二醇（E-2）水平升高对新鲜体外受精（IVF）-胚胎移植（ET）周期后足月单胎出生体重的影响。回顾性队列研究，对2004年1月至2013年2月期间所有启动新鲜IVF-ET周期导致活产的患者进行研究。估计了hCG触发当天E-2水平高于或低于我们诊所E-2值95%临界值（3，069.2 pg/mL）的患者中低出生体重（LBW）足月单胎的发生率。排除多胎妊娠和双胎妊娠减灭。2939例单胎活产被确定纳入。147例（5%）和2792例（95%）活产单胎分别发生在E-2峰值水平高于和低于3，069.2 pg/mL的患者中。足月低出生体重的总体发生率在> 3，069.2 pg/mL组中为5.4%，而在千分之一货币符号3，069.2 pg/mL组中为2.4%（P = 0.038）。hCG给药当天的E-2水平> 3，069.2 pg/mL与LBW足月单胎的几率增加相关（OR = 2.29; 95% CI = 1.03-5.11）。当调整母亲年龄时，增加的几率保持不变（aOR = 2.29; 95% CI = 1.02-5.14; P = 0.037），分娩时胎龄（aOR = 2.04; 95% CI = 1.22-3.98; P = 0.025），第3天与囊胚移植相比（aOR = 2.5; 95%CI = 1.11-5.64; P = 0.023）。峰值E-2水平> 3，069.2 pg/mL与新鲜IVF-ET周期后LBW足月单胎的几率增加相关。如果计划进行新鲜移植，则旨在不超过3，000 pg/mL的E-2水平的保守刺激方案可能有利于胎盘形成和胎儿生长。
To investigate the impact of elevated serum estradiol (E-2) levels on the day of hCG trigger on the birth weight of term singletons after fresh In Vitro Fertilization (IVF)-Embryo Transfer (ET) cycles.Retrospective cohort study of all patients initiating fresh IVF-ET cycles resulting in live births between January 2004 and February 2013. The incidence of low birthweight (LBW) term singletons in patients with E-2 levels on day of hCG trigger above or below the 95 % cutoff for E-2 values in our clinic (3,069.2 pg/mL) was estimated. Multiple gestations and vanishing twin pregnancies were excluded.Two thousand nine hundred thirty-nine singleton live births were identified for inclusion. One hundred forty seven (5 %) and 2792 (95 %) live singleton births occurred in patients with peak E-2 levels above and below 3,069.2 pg/mL, respectively. The overall incidence of term LBW was 5.4 % in the > 3,069.2 pg/mL group compared to 2.4 % in the a parts per thousand currency sign3,069.2 pg/mL group (P = .038). An E-2 level > 3,069.2 pg/mL on the day of hCG administration was associated with increased odds of LBW term singletons (OR = 2.29; 95 % CI = 1.03-5.11). The increased odds remained unchanged when adjusting for maternal age (aOR = 2.29; 95 % CI = 1.02-5.14; P = .037), gestational age at delivery (aOR = 2.04; 95 % CI = 1.22-3.98; P = .025), and day 3 versus blastocyst transfer (aOR = 2.5; 95 % CI = 1.11-5.64; P = .023).Peak E-2 level > 3,069.2 pg/mL is associated with increased odds of LBW term singletons after fresh IVF-ET cycles. Conservative stimulation protocols aiming not to exceed an E-2 level of 3,000 pg/mL may be advantageous for placentation and fetal growth if a fresh transfer is planned.