Huang Wenjie, Wei Liuyan, Tang Juan, Nong Liuying, Tang Ni, Wen Qiuyue, Qin Zuxing, Xu Lixiang, Li Jingjing, Fan Li
Department of Reproductive Medicine, Guangzhou Women and Children's Medical center Liuzhou Hospital, Liuzhou, Guangxi, China.
Liuzhou maternity and Child Healthcare Hospital, Liuzhou, Guangxi, China.
Sci Rep. 2025 May 5;15(1):15617. doi: 10.1038/s41598-025-00200-5.
This study aimed to evaluate the predictive value of relative change in E2 levels during controlled ovarian stimulation (COS) on embryo development and pregnancy outcomes in assisted reproductive technology (ART). We retrospectively analyzed 9,376 patients who underwent their first fresh ART cycle from January 1, 2020, to December 31, 2022. Patients were classified into four groups based on relative change in E2 levels: low response group, moderate response group, moderate-high response group, and high response group. The primary outcomes were blastocyst formation rate, clinical pregnancy rate, and live birth rate, while secondary outcomes included miscarriage rate and ectopic pregnancy rate. Most cycles (96.5%) demonstrated an increase in E2 levels during COS. The blastocyst formation rate significantly increased across the groups (low response group: 0.13, moderate response group: 0.21, moderate-high response group: 0.28, high response group: 0.34; P < 0.001). Multivariable logistic regression showed significantly higher blastocyst formation rates in the moderate response group (adjusted OR = 2.012, 95% CI: 1.687-2.399), moderate-high response group (adjusted OR = 4.613, 95% CI: 3.853-5.523), and high response group (adjusted OR = 11.295, 95% CI: 9.192-13.880) compared to the low response group. Both clinical pregnancy rate and live birth rate were significantly higher in the moderate-high response group and high response group compared to the low response group (clinical pregnancy rate: 54.5% and 61.5% vs. 35.5%, adjusted RR = 1.21 [95% CI: 1.03-1.42] and 1.27 [95% CI: 1.08-1.51]; live birth rate: 44.9% and 52.0% vs. 25.7%, adjusted RR = 1.27 [95% CI: 1.06-1.52] and 1.35 [95% CI: 1.11-1.64]). However, no significant differences were observed in either clinical pregnancy rate or live birth rate between the moderate response group and low response group (clinical pregnancy rate: adjusted RR = 1.07 [95% CI: 0.91-1.25]; live birth rate: adjusted RR = 1.11 [95% CI: 0.92-1.33]). No significant differences in miscarriage rate or ectopic pregnancy rate were observed across the groups. Higher E2 responses were associated with improved embryo development and better pregnancy outcomes.
本研究旨在评估控制性卵巢刺激（COS）期间雌二醇（E2）水平的相对变化对辅助生殖技术（ART）中胚胎发育和妊娠结局的预测价值。我们回顾性分析了2020年1月1日至2022年12月31日期间接受首次新鲜ART周期治疗的9376例患者。根据E2水平的相对变化将患者分为四组：低反应组、中等反应组、中等高反应组和高反应组。主要结局为囊胚形成率、临床妊娠率和活产率，次要结局包括流产率和异位妊娠率。大多数周期（96.5%）在COS期间E2水平升高。各组间囊胚形成率显著增加（低反应组：0.13，中等反应组：0.21，中等高反应组：0.28，高反应组：0.34；P < 0.001）。多变量逻辑回归显示，与低反应组相比，中等反应组（调整后OR = 2.012，95%CI：1.687 - 2.399）、中等高反应组（调整后OR = 4.613，95%CI：3.853 - 5.523）和高反应组（调整后OR = 11.295，95%CI：9.192 - 13.880）的囊胚形成率显著更高。与低反应组相比，中等高反应组和高反应组的临床妊娠率和活产率均显著更高（临床妊娠率：54.5%和61.5%对35.5%，调整后RR = 1.21 [95%CI：1.03 - 1.42]和1.27 [95%CI：1.08 - 1.51]；活产率：44.9%和52.0%对25.7%，调整后RR = 具有更高的E2反应与改善的胚胎发育和更好的妊娠结局相关。 1.27 [95%CI：1.06 - 1.52]和1.35 [95%CI：1.11 - 1.64]）。然而，中等反应组和低反应组之间的临床妊娠率或活产率均未观察到显著差异（临床妊娠率：调整后RR = 1.07 [95%CI：0.91 - 1.25]；活产率：调整后RR = 1.11 [95%CI：0.92 - 1.33]）。各组间流产率或异位妊娠率未观察到显著差异。更高的E2反应与改善的胚胎发育和更好的妊娠结局相关。 （注：最后一句英文重复，中文译文也重复了一遍，原文可能存在此问题）
