Reproductive Medicine Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China.
Sci Rep. 2021 Mar 16;11(1):6084. doi: 10.1038/s41598-021-85692-7.
Oestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.
雌二醇是卵泡发育和子宫内膜容受性的重要激素，与新鲜体外受精-胚胎移植（IVF-ET）周期的临床结局密切相关。在控制性卵巢超刺激（COH）期间，必然会出现雌二醇（E2）水平升高，但其对 IVF-ET 结局的影响存在争议。本回顾性研究旨在评估人绒毛膜促性腺激素（hCG）给药日血清雌二醇（E2）水平升高与 IVF-ET 后新生儿出生体重之间的关系。2009 年 8 月至 2017 年 2 月，郑州大学第一附属医院对 3659 例新鲜 IVF-ET 周期的不孕患者进行了回顾性分析。根据 hCG 给药日血清 E2 水平将患者分为六组：第 1 组（血清 E2 水平≤1000 pg/ml，n=230）、第 2 组（血清 E2 水平在 1001-2000 pg/ml 之间，n=524）、第 3 组（血清 E2 水平在 2001-3000 pg/ml 之间，n=783）、第 4 组（血清 E2 水平在 3001-4000 pg/ml 之间，n=721）、第 5 组（血清 E2 水平在 4001-5000 pg/ml 之间，n=548）和第 6 组（血清 E2 水平>5000 pg/ml，n=852）。采用单因素线性回归评估各因素与结局指标的独立相关性。采用多因素逻辑回归校正混杂因素。LBW 发生率如下：3.0%（第 1 组）、2.9%（第 2 组）、1.9%（第 3 组）、2.9%（第 4 组）、2.9%（第 5 组）和 2.0%（第 6 组）（P=0.629）。六组之间新生儿 LBW 的发生率无统计学差异。我们未检测到卵巢刺激期间血清 E2 峰值与 IVF-ET 后新生儿出生体重之间的关联。本回顾性队列研究结果表明，卵巢刺激期间血清 E2 峰值水平与 IVF 周期中的出生体重无关。此外，较高的 E2 水平与 LBW 风险增加之间没有关联。我们的观察表明，COS 期间的高雌激素环境似乎对 IVF 后代的出生体重没有不良影响。尽管本研究提供了一些参考，但由于历史原因，并未纳入与产科相关的因素。COS 期间高雌激素环境对 IVF 后代出生体重的影响仍需要进一步研究。
