Karaçin Pınar, Özelçi Runa, Kumcu Enes, Kaya Kaplanoğlu Dilek, Dilbaz Serdar, Üstün Yaprak
Department of Gynecology, Etlik City Hospital, Ankara 06010, Türkiye.
Department of Gynecology, Etlik Zubeyde Hanim Training and Research Hospital, Ankara 06010, Türkiye.
Medicina (Kaunas). 2025 Apr 17;61(4):741. doi: 10.3390/medicina61040741.
The aim of this study is to evaluate the relationship between serum estradiol (E2) levels measured on the day of antagonist administration and live birth rates (LBRs) in women undergoing IVF-ET with an antagonist protocol. Data from women who underwent IVF-ET with an antagonist protocol between 2011 and 2023 were retrospectively analyzed. Patients were divided into five groups on the basis of serum E2 levels measured on the day of antagonist administration (Group I: E2 < 400 pg/mL, Group II: 400 ≤ E2 < 650 pg/mL, Group III: 650 ≤ E2 < 800 pg/mL, Group IV:800 ≤ E2 < 1000 pg/mL, and Group V: E2 ≥ 1000 pg/mL). The independent effect of serum E2 levels on live birth was analyzed via an adjusted regression model. A total of 1613 patients were included in the study. The overall LBR was 32.1%. The LBRs for Groups I, II, III, IV, and V were 28.9%, 37.8%, 26.4%, 32.2%, and 34.1%, respectively ( = 0.017). In the adjusted regression model, serum E2 levels measured on the day of antagonist administration < 400 pg/mL (OR: 0.752, 95% CI: 0.580-0.999, = 0.048) and 650 ≤ E2 < 800 pg/mL (OR: 0.595, 95% CI: 0.388-0.911, = 0.011) were identified as factors that reduce the likelihood of a live birth, adjusting for age, infertility duration, body mass index (BMI), cycle number, quality of embryo, and number of embryos transferred. The serum E2 level associated with the highest LBR in women undergoing IVF-ET with an antagonist protocol was found to be in the range of 400-650. Serum E2 levels < 400 pg/mL or in the range of 650-800 pg/mL were statistically significantly associated with a reduced LBR.
本研究的目的是评估在接受拮抗剂方案的体外受精-胚胎移植（IVF-ET）的女性中，拮抗剂给药当天测得的血清雌二醇（E2）水平与活产率（LBR）之间的关系。对2011年至2023年间接受拮抗剂方案IVF-ET的女性数据进行回顾性分析。根据拮抗剂给药当天测得的血清E2水平将患者分为五组（I组：E2<400 pg/mL，II组：400≤E2<650 pg/mL，III组：650≤E2<800 pg/mL，IV组：800≤E2<1000 pg/mL，V组：E2≥1000 pg/mL）。通过调整回归模型分析血清E2水平对活产的独立影响。本研究共纳入1613例患者。总体活产率为32.1%。I、II、III、IV和V组的活产率分别为28.9%、37.8%、26.4%、32.2%和34.1%（P=0.017）。在调整回归模型中，在调整年龄、不孕持续时间、体重指数（BMI）、周期数、胚胎质量和移植胚胎数后，拮抗剂给药当天测得的血清E2水平<400 pg/mL（OR：0.752，95%CI：0.580-0.999，P=0.048）和650≤E2<800 pg/mL（OR：0.595，95%CI：0.388-0.911，P=0.011）被确定为降低活产可能性的因素。在接受拮抗剂方案IVF-ET的女性中，与最高活产率相关的血清E2水平在400-650范围内。血清E2水平<400 pg/mL或在650-800 pg/mL范围内与活产率降低在统计学上显著相关。
