Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Endocrinol (Lausanne). 2021 Mar 10;12:622081. doi: 10.3389/fendo.2021.622081. eCollection 2021.
down-regulation has been widely used in IVF treatment; however, it lacks reports on the impact of down-regulation on obstetrics and perinatal outcomes. The purpose of this study was to compare the obstetrics and perinatal outcomes among different down-regulation conditions.
this is a retrospective cohort study on 3578 patients achieving cumulative singleton clinical pregnancy after their first oocytes retrieval cycle. Patients were grouped according to the serum estradiol after down-regulation (E2D) into three groups: <30, 30-55, >55 pg/ml. The obstetrics and perinatal outcomes, and live-birth rate per clinical pregnancy were main outcome measures. In the subgroup analysis, patients were further divided according to the mode of transfer. ANOVA, chi-square test, multivariate logistic regression, and multivariate general linear model were performed for statistical analysis.
the patients with E2D <30, 30-55, >55 pg/ml had similar live-birth rates. The patients with E2D <30 pg/ml had a lower risk of hypertension disorders than those with E2D 30-55 pg/ml. No difference was found in the risks of placenta previa, placenta abruption, premature rupture of membrane, hemorrhage, gestational diabetes mellitus, or intrauterine growth restriction. The newborns in the group with E2D <30 pg/ml had a lower risk of PICU admission than those in the group with E2D >55 pg/ml. There was no difference in the risks of congenital anomalies or mortality among the three groups. No differences were found in the gestational week, percentages of preterm birth and very preterm birth, birth weight, percentages of low birth weight and very low birth weight, delivery mode, or sex of newborn. Subgroup analysis showed that E2D 30-55 pg/ml was associated with a higher risk of low birth weight in patients with one fresh transfer + frozen transfer(s).
Down-regulation has no effect on the live-birth rate per clinical pregnancy. Patients with E2D <30 pg/ml may have advantages regarding lower risks of both maternal hypertension and newborn PICU admission. E2D 30-55 pg/ml may be associated with low birth weight in patients with relatively low quality embryos.
下调已广泛应用于体外受精治疗中，但缺乏关于下调对产科和围产结局影响的报道。本研究旨在比较不同下调情况下的产科和围产结局。
这是一项回顾性队列研究，纳入了 3578 名首次取卵周期后获得累积单胎临床妊娠的患者。根据下调后血清雌二醇（E2D）将患者分为 3 组：<30、30-55、>55pg/ml。主要观察指标为产科和围产结局及每例临床妊娠的活产率。在亚组分析中，根据转移方式进一步将患者分组。采用方差分析、卡方检验、多变量逻辑回归和多变量广义线性模型进行统计学分析。
E2D<30、30-55、>55pg/ml 组的活产率相似。E2D<30pg/ml 组高血压疾病的风险低于 E2D 30-55pg/ml 组。胎盘前置、胎盘早剥、胎膜早破、出血、妊娠期糖尿病或宫内生长受限的风险在各组间无差异。E2D<30pg/ml 组新生儿入住 PICU 的风险低于 E2D>55pg/ml 组。三组间先天性畸形或死亡率无差异。E2D 30-55pg/ml 组在新鲜胚胎移植+冻融胚胎移植（s）患者中与较低的出生体重相关。
下调对每例临床妊娠的活产率无影响。E2D<30pg/ml 患者的母亲高血压和新生儿入住 PICU 的风险可能较低。E2D 30-55pg/ml 可能与胚胎质量相对较低的患者的低出生体重有关。
