Center for Reproductive Medicine, Guangdong Women and Children Hospital, Guangzhou, Guangdong Province, China.
BJOG. 2021 Dec;128(13):2092-2100. doi: 10.1111/1471-0528.16777. Epub 2021 Jun 27.
To study whether serum estradiol (E2) levels prior to progesterone administration in the artificial endometrial preparation (AEP) of frozen-thawed blastocyst transfer affect the live birth rate.
Retrospective cohort study.
Tertiary-care academic medical centre.
A total of 3857 frozen-thawed blastocyst transfer cycles were divided into three groups: <200 pg/ml (n = 1676); 200-399 pg/ml (n = 1296); and ≥400 pg/ml (n = 885), based on the 25th (182.3 pg/ml) and 75th percentile (390.2 pg/ml) of serum E2 level prior to progesterone administration.
Univariable and multivariable logistic regression analysis was performed.
The primary outcome of the study was the live birth rate and the secondary outcomes included clinical pregnancy rate, pregnancy loss rate, neonatal birthweight, Z-score, and small for gestational age (SGA).
Compared with the reference group, accounting for major covariates, the live birth rate significantly decreased in the '≥400 pg/ml' group (adjusted OR 0.71, 95% CI 0.59-0.85). Compared with the reference group, there was an association between the E2 level in the '≥400 pg/ml' group and a decrease in the clinical pregnancy rate (adjusted OR 0.74, 95% CI 0.61-0.89). Compared with the reference group, the pregnancy loss rate significantly increased in the '≥400 pg/ml' group (adjusted OR 1.45, 95% CI 1.08-1.93). The E2 levels did not affect neonatal birthweight, Z-score, and SGA among singletons.
High serum E2 levels prior to progesterone administration in AEP are associated with a decreased live birth rate after frozen-thawed blastocyst transfer.
High serum E2 levels prior to progesterone administration in artificial FET are associated with a decreased live birth rate after frozen-thawed blastocyst transfer.
研究冻融胚胎移植中人工内膜准备（AEP）前孕酮给药前血清雌二醇（E2）水平是否影响活产率。
回顾性队列研究。
三级保健学术医疗中心。
根据孕酮给药前血清 E2 水平的第 25 百分位（182.3pg/ml）和第 75 百分位（390.2pg/ml），将 3857 个冻融胚胎移植周期分为三组：<200pg/ml（n=1676）；200-399pg/ml（n=1296）；和≥400pg/ml（n=885）。
进行单变量和多变量逻辑回归分析。
本研究的主要结局是活产率，次要结局包括临床妊娠率、妊娠丢失率、新生儿出生体重、Z 评分和小于胎龄儿（SGA）。
与参考组相比，在校正了主要混杂因素后，“≥400pg/ml”组的活产率显著降低（调整后的 OR 0.71，95%CI 0.59-0.85）。与参考组相比，“≥400pg/ml”组 E2 水平与临床妊娠率下降相关（调整后的 OR 0.74，95%CI 0.61-0.89）。与参考组相比，“≥400pg/ml”组的妊娠丢失率显著增加（调整后的 OR 1.45，95%CI 1.08-1.93）。E2 水平对单胎新生儿出生体重、Z 评分和 SGA 无影响。
AEP 中孕酮给药前高血清 E2 水平与冻融胚胎移植后活产率降低有关。
