Do spontaneously decreasing estradiol eve s prior to triggering of ovulation adversely impact in vitro fertilization outcomes?
Do spontaneously decreasing estradiol eve s prior to triggering of ovulation adversely impact in vitro fertilization outcomes?
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DOI：
10.5653/cerm.2019.03419
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发表时间：
2020-09-01
影响因子：
1.8
通讯作者：
Friedler, Shevach
中科院分区：
文献类型：
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作者：
Grin, Leonti;Berkovitz-Shperling, Roza;Friedler, Shevach
目的：本研究的目的是探讨自发性降低血清雌二醇（SE）水平对体外受精（IVF）结局的潜在不良影响。方法：本回顾性单受试者研究分析了2010年至2017年在医院IVF单位进行的NF周期。总共分析了2，417个周期。仅纳入人绒毛膜促性腺激素（hCG）触发前SE自发降低的周期。每例患者作为自己的对照，并分析后续周期的复发性SE降低。结果：除了hCG触发当天的SE中位数（899.7 pg/mL;四分位距[IQR]，193- 2，116 pg/mL vs. 1，566.8 pg/mL; IQR，249- 2，970 pg/mL; p < 0.001）外，研究组（SE降低）和对照组之间的周期特征相似。相对于对照组，研究组的总卵母细胞数量显著较少（5 [IQR，2-9] vs. 7 [IQR，3-11]; p = 0.002），中期细胞（MII）卵母细胞数量显著较少（3 [IQR，1-6] vs. 4 [IQR，2-8]; p= 0.001）。研究组的卵裂期胚胎少于对照组（3 [IQR，1-6] vs. 4 [IQR，2-7]; p= 0.012）。与减少20%的周期相比，获得的总卵母细胞和MII卵母细胞显着减少。SE下降复发的patients.Conclusion：自发性下降的SE水平的不利影响IVF的结果，减少的百分比和获得的卵母细胞的数量之间的线性相关性。SE降低可在以后的周期中重复。
Objective: The aim of this study was to explore the potential adverse effect of spontaneously decreasing serum estradiol (SE) levels on in vitro fertilization (IVF) outcomes.Methods: This retrospective single-subject study analyzed NF cycles conducted at a hospital IVF unit between 2010 and 2017. Overall, 2,417 cycles were analyzed. Only cycles with spontaneously decreasing SE before human chorionic gonadotropin (hCG) triggering were included. Each patient served as her own control, and subsequent cycles were analyzed for recurrent SE decreases. The main outcome was the number of oocytes retrieved.Results: Cycle characteristics were similar between the study (SE decrease) and control groups, with the exception of the median SE on the day of hCG triggering (899.7 pg/mL; interquartile range [IQR], 193-2,116 pg/mL vs. 1,566.8 pg/mL; IQR, 249-2,970 pg/mL; p < 0.001). The study group, relative to the control group, had significantly fewer total oocytes (5 [IQR, 2-9] vs. 7 [IQR, 3-11]; p = 0.002) and significantly fewer metaphasell(MII) oocytes (3 [IQR, 1-6] vs. 4 [IQR, 2-8]; p= 0.001) retrieved. The study group had fewer cleavage-stage embryos than the control cycles (3 [IQR, 1-6] vs. 4 [IQR, 2-7]; p= 0.012). Compared to cycles with a 20% decrease had significantly fewer total and MII oocytes retrieved. SE decrease recurred in 12% of patients.Conclusion: A spontaneous decrease in SE levels adversely affected IVF outcomes, with a linear correlation between the percentage decrease and the number of oocytes retrieved. SE decrease can repeat in later cycles.