Sun Na, Sun Ping-Ping, Cao Hai-Ru, Ma Hua-Gang
The Reproductive Medicine Center of Weifang People's Hospital, Weifang, Shandong, China.
Medicine (Baltimore). 2025 Mar 7;104(10):e41727. doi: 10.1097/MD.0000000000041727.
High serum estradiol levels may reduce the success of conception and live birth in both in vitro fertilization and frozen embryo transfer (FET). This retrospective study sought to determine whether an association exists between decreasing the serum estradiol level and the clinical outcome following programmed FET cycles. The analysis retrieved the data of patients who underwent programmed FET cycles at the Center of Reproductive Medicine of Weifang People's Hospital from January 2022 to March 2023. The pregnancy outcomes were compared between patient groups with different estradiol levels but otherwise identical profiles. Of all 769 included patients, 188 received 3 mg/d estradiol valerate (group A) and 581 received 4 mg/d 17β-estradiol (group B). Of group B patients, 186 (group BP) with identical baseline clinical data as patients in group A were selected by using propensity score matching. While the serum estradiol level was much lower in those receiving 3 mg/d estradiol valerate (group A) than those receiving 4 mg/d 17β-estradiol (group BP), the endometrial thickness was not affected by the medication regimen. Both groups had comparable pregnancy outcomes, including clinical pregnancy, implantation, early miscarriage, ectopic pregnancy, and live birth rate. In programmed FET cycles, decreasing the serum level of estradiol does not significantly impact the pregnancy outcome.
高血清雌二醇水平可能会降低体外受精和冷冻胚胎移植（FET）的受孕成功率和活产率。这项回顾性研究旨在确定降低血清雌二醇水平与程序化FET周期后的临床结局之间是否存在关联。该分析检索了2022年1月至2023年3月在潍坊市人民医院生殖医学中心接受程序化FET周期的患者数据。对雌二醇水平不同但其他情况相同的患者组的妊娠结局进行了比较。在所有纳入的769例患者中，188例接受了3mg/d戊酸雌二醇（A组），581例接受了4mg/d 17β-雌二醇（B组）。在B组患者中，通过倾向评分匹配选择了186例（BP组）与A组患者基线临床数据相同的患者。虽然接受3mg/d戊酸雌二醇的患者（A组）血清雌二醇水平远低于接受4mg/d 17β-雌二醇的患者（BP组），但子宫内膜厚度不受用药方案的影响。两组的妊娠结局相当，包括临床妊娠、着床、早期流产、异位妊娠和活产率。在程序化FET周期中，降低血清雌二醇水平不会显著影响妊娠结局。
