Skip to main content
Erschienen in: Archives of Gynecology and Obstetrics 2/2017

17.11.2016 | General Gynecology

Effect of elevated estradiol levels on the hCG administration day on IVF pregnancy and birth outcomes in the long GnRH-agonist protocol: analysis of 3393 cycles

verfasst von: Meimei Wang, Cuifang Hao, Hongchu Bao, Xin Huang, Zhenteng Liu, Wei Zhang, Fenghua Li

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 2/2017

Einloggen, um Zugang zu erhalten

Abstract

Introduction

This retrospective study aimed to evaluate the association between elevated serum estradiol (E 2) levels on the human chorionic gonadotrophin (hCG) administration day and in vitro fertilization (IVF) pregnancy and birth outcomes in the long GnRH-agonist protocol.

Methods

This study analyzed the data of 3393 infertile women who underwent initial fresh IVF. The patients were categorized into high and low E 2 groups based on their serum E 2 levels on the hCG day. Pregnancy and birth outcomes were compared.

Results

The implantation rate, clinical pregnancy rate, and live birth rate were all significantly higher in the high E 2 group than in the low E 2 group (p < 0.05). The good-quality embryo rate and abortion rate did not significantly differ between the two groups. There were no significant differences in the mode of delivery, gestational age, birth weight, and fetal gender between the two groups. Furthermore, there were no differences in the risk of preterm birth, low birth weight, and fetal malformation between the two groups in 860 single live births. Subgroup analysis of singleton pregnancies in the high E 2 (E 2 ≥ 3757 pg/mL) group revealed a significant increase in abortion rate in the age group of ≥37 years.

Conclusions

Elevated serum E 2 levels associated with controlled ovarian stimulation did not increase the risks of preterm birth, low birth weight, and fetal malformation. High E 2 on the hCG day had no detrimental effect on the implantation rate, clinical pregnancy rate, and live birth rate.
Literatur
1.
2.
Zurück zum Zitat Pittaway DE, Wentz AC (1983) Evaluation of the exponential rise of serum estradiol concentrations in human menopausal gonadotropin-induced cycles. Fertil Steril 40(6):763–767CrossRefPubMed Pittaway DE, Wentz AC (1983) Evaluation of the exponential rise of serum estradiol concentrations in human menopausal gonadotropin-induced cycles. Fertil Steril 40(6):763–767CrossRefPubMed
4.
Zurück zum Zitat Chenette PE, Sauer MV, Paulson RJ (1990) Very high serum estradiol levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril 54(5):858–863CrossRefPubMed Chenette PE, Sauer MV, Paulson RJ (1990) Very high serum estradiol levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril 54(5):858–863CrossRefPubMed
5.
Zurück zum Zitat Gelety TJ, Buyalos RP (1995) The influence of supraphysiologic estradiol levels on human nidation. J Assist Reprod Genet 12(7):406–412CrossRefPubMed Gelety TJ, Buyalos RP (1995) The influence of supraphysiologic estradiol levels on human nidation. J Assist Reprod Genet 12(7):406–412CrossRefPubMed
6.
Zurück zum Zitat Simon C, Cano F, Valbuena D, Remohi J, Pellicer A (1995) Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Hum Reprod 10(9):2432–2437CrossRefPubMed Simon C, Cano F, Valbuena D, Remohi J, Pellicer A (1995) Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Hum Reprod 10(9):2432–2437CrossRefPubMed
7.
Zurück zum Zitat Ng EH (2000) What is the threshold value for serum estradiol levels associated with adverse IVF outcomes? Fertil Steril 73(5):1071–1072CrossRefPubMed Ng EH (2000) What is the threshold value for serum estradiol levels associated with adverse IVF outcomes? Fertil Steril 73(5):1071–1072CrossRefPubMed
9.
Zurück zum Zitat Kyrou D, Popovic-Todorovic B, Fatemi HM, Bourgain C, Haentjens P, Van Landuyt L et al (2009) Does the estradiol level on the day of human chorionic gonadotrophin administration have an impact on pregnancy rates in patients treated with rec-FSH/GnRH antagonist? Hum Reprod 24(11):2902–2909. doi:10.1093/humrep/dep290 CrossRefPubMed Kyrou D, Popovic-Todorovic B, Fatemi HM, Bourgain C, Haentjens P, Van Landuyt L et al (2009) Does the estradiol level on the day of human chorionic gonadotrophin administration have an impact on pregnancy rates in patients treated with rec-FSH/GnRH antagonist? Hum Reprod 24(11):2902–2909. doi:10.​1093/​humrep/​dep290 CrossRefPubMed
11.
Zurück zum Zitat Hu XL, Feng C, Lin XH, Zhong ZX, Zhu YM, Lv PP et al (2014) High maternal serum estradiol environment in the first trimester is associated with the increased risk of small-for-gestational-age birth. J Clin Endocrinol Metab 99(6):2217–2224. doi:10.1210/jc.2013-3362 CrossRefPubMed Hu XL, Feng C, Lin XH, Zhong ZX, Zhu YM, Lv PP et al (2014) High maternal serum estradiol environment in the first trimester is associated with the increased risk of small-for-gestational-age birth. J Clin Endocrinol Metab 99(6):2217–2224. doi:10.​1210/​jc.​2013-3362 CrossRefPubMed
12.
Zurück zum Zitat Sunkara SK, La Marca A, Seed PT, Khalaf Y (2015) Increased risk of preterm birth and low birthweight with very high number of oocytes following IVF: an analysis of 65 868 singleton live birth outcomes. Hum Reprod 30(6):1473–1480. doi:10.1093/humrep/dev076 CrossRefPubMed Sunkara SK, La Marca A, Seed PT, Khalaf Y (2015) Increased risk of preterm birth and low birthweight with very high number of oocytes following IVF: an analysis of 65 868 singleton live birth outcomes. Hum Reprod 30(6):1473–1480. doi:10.​1093/​humrep/​dev076 CrossRefPubMed
13.
Zurück zum Zitat Pereira N, Reichman DE, Goldschlag DE, Lekovich JP, Rosenwaks Z (2015) Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles. J Assist Reprod Genet 32(4):527–532. doi:10.1007/s10815-015-0434-1 CrossRefPubMedPubMedCentral Pereira N, Reichman DE, Goldschlag DE, Lekovich JP, Rosenwaks Z (2015) Impact of elevated peak serum estradiol levels during controlled ovarian hyperstimulation on the birth weight of term singletons from fresh IVF-ET cycles. J Assist Reprod Genet 32(4):527–532. doi:10.​1007/​s10815-015-0434-1 CrossRefPubMedPubMedCentral
15.
Zurück zum Zitat Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K et al (2009) International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril 92(5):1520–1524. doi:10.1016/j.fertnstert.2009.09.009 CrossRefPubMed Zegers-Hochschild F, Adamson GD, de Mouzon J, Ishihara O, Mansour R, Nygren K et al (2009) International Committee for Monitoring Assisted Reproductive Technology (ICMART) and the World Health Organization (WHO) revised glossary of ART terminology, 2009. Fertil Steril 92(5):1520–1524. doi:10.​1016/​j.​fertnstert.​2009.​09.​009 CrossRefPubMed
16.
Zurück zum Zitat Imudia AN, Goldman RH, Awonuga AO, Wright DL, Styer AK, Toth TL (2014) The impact of supraphysiologic serum estradiol levels on peri-implantation embryo development and early pregnancy outcome following in vitro fertilization cycles. J Assist Reprod Genet 31(1):65–71. doi:10.1007/s10815-013-0117-8 CrossRefPubMed Imudia AN, Goldman RH, Awonuga AO, Wright DL, Styer AK, Toth TL (2014) The impact of supraphysiologic serum estradiol levels on peri-implantation embryo development and early pregnancy outcome following in vitro fertilization cycles. J Assist Reprod Genet 31(1):65–71. doi:10.​1007/​s10815-013-0117-8 CrossRefPubMed
17.
Zurück zum Zitat Sharara FI, McClamrock HD (1999) High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril 72(3):401–405CrossRefPubMed Sharara FI, McClamrock HD (1999) High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril 72(3):401–405CrossRefPubMed
18.
Zurück zum Zitat Yu Ng EH, Yeung WS, Yee Lan Lau E, So WW, Ho PC (2000) High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles. Hum Reprod 15(2):250–255CrossRefPubMed Yu Ng EH, Yeung WS, Yee Lan Lau E, So WW, Ho PC (2000) High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cycles. Hum Reprod 15(2):250–255CrossRefPubMed
19.
Zurück zum Zitat Taskin EA, Atabekoglu CS, Musali N, Oztuna D, Sonmezer M (2014) Association of serum estradiol levels on the day of hCG administration with pregnancy rates and embryo scores in fresh ICSI/ET cycles down regulated with either GnRH agonists or GnRH antagonists. Arch Gynecol Obstet 289(2):399–405. doi:10.1007/s00404-013-2984-8 CrossRefPubMed Taskin EA, Atabekoglu CS, Musali N, Oztuna D, Sonmezer M (2014) Association of serum estradiol levels on the day of hCG administration with pregnancy rates and embryo scores in fresh ICSI/ET cycles down regulated with either GnRH agonists or GnRH antagonists. Arch Gynecol Obstet 289(2):399–405. doi:10.​1007/​s00404-013-2984-8 CrossRefPubMed
21.
Zurück zum Zitat Zhao Z, Li Y, Chen H, Huang L, Zhao F, Yu Q et al (2014) Xylaria nigripes mitigates spatial memory impairment induced by rapid eye movement sleep deprivation. Int J Clin Exp Med 7(2):356–362PubMedPubMedCentral Zhao Z, Li Y, Chen H, Huang L, Zhao F, Yu Q et al (2014) Xylaria nigripes mitigates spatial memory impairment induced by rapid eye movement sleep deprivation. Int J Clin Exp Med 7(2):356–362PubMedPubMedCentral
23.
Zurück zum Zitat Chen CH, Zhang X, Barnes R, Confino E, Milad M, Puscheck E et al (2003) Relationship between peak serum estradiol levels and treatment outcome in in vitro fertilization cycles after embryo transfer on day 3 or day 5. Fertil Steril 80(1):75–79CrossRefPubMed Chen CH, Zhang X, Barnes R, Confino E, Milad M, Puscheck E et al (2003) Relationship between peak serum estradiol levels and treatment outcome in in vitro fertilization cycles after embryo transfer on day 3 or day 5. Fertil Steril 80(1):75–79CrossRefPubMed
24.
Zurück zum Zitat Imudia AN, Awonuga AO, Doyle JO, Kaimal AJ, Wright DL, Toth TL et al (2012) Peak serum estradiol level during controlled ovarian hyperstimulation is associated with increased risk of small for gestational age and preeclampsia in singleton pregnancies after in vitro fertilization. Fertil Steril 97(6):1374–1379. doi:10.1016/j.fertnstert.2012.03.028 CrossRefPubMed Imudia AN, Awonuga AO, Doyle JO, Kaimal AJ, Wright DL, Toth TL et al (2012) Peak serum estradiol level during controlled ovarian hyperstimulation is associated with increased risk of small for gestational age and preeclampsia in singleton pregnancies after in vitro fertilization. Fertil Steril 97(6):1374–1379. doi:10.​1016/​j.​fertnstert.​2012.​03.​028 CrossRefPubMed
25.
28.
Zurück zum Zitat Chen QJ, Sun XX, Li L, Gao XH, Wu Y, Gemzell-Danielsson K et al (2007) Effects of ovarian high response on implantation and pregnancy outcome during controlled ovarian hyperstimulation (with GnRH agonist and rFSH). Acta Obstet Gynecol Scand 86(7):849–854. doi:10.1080/00016340701415152 CrossRefPubMed Chen QJ, Sun XX, Li L, Gao XH, Wu Y, Gemzell-Danielsson K et al (2007) Effects of ovarian high response on implantation and pregnancy outcome during controlled ovarian hyperstimulation (with GnRH agonist and rFSH). Acta Obstet Gynecol Scand 86(7):849–854. doi:10.​1080/​0001634070141515​2 CrossRefPubMed
29.
Zurück zum Zitat Valbuena D, Jasper M, Remohi J, Pellicer A, Simon C (1999) Ovarian stimulation and endometrial receptivity. Hum Reprod 14(Suppl 2):107–111CrossRefPubMed Valbuena D, Jasper M, Remohi J, Pellicer A, Simon C (1999) Ovarian stimulation and endometrial receptivity. Hum Reprod 14(Suppl 2):107–111CrossRefPubMed
30.
Zurück zum Zitat Levi AJ, Drews MR, Bergh PA, Miller BT, Scott RT Jr (2001) Controlled ovarian hyperstimulation does not adversely affect endometrial receptivity in in vitro fertilization cycles. Fertil Steril 76(4):670–674CrossRefPubMed Levi AJ, Drews MR, Bergh PA, Miller BT, Scott RT Jr (2001) Controlled ovarian hyperstimulation does not adversely affect endometrial receptivity in in vitro fertilization cycles. Fertil Steril 76(4):670–674CrossRefPubMed
32.
Zurück zum Zitat Kalra SK, Ratcliffe SJ, Dokras A (2013) Is the fertile window extended in women with polycystic ovary syndrome? Utilizing the Society for Assisted Reproductive Technology registry to assess the impact of reproductive aging on live-birth rate. Fertil Steril 100(1):208–213. doi:10.1016/j.fertnstert.2013.02.055 CrossRefPubMed Kalra SK, Ratcliffe SJ, Dokras A (2013) Is the fertile window extended in women with polycystic ovary syndrome? Utilizing the Society for Assisted Reproductive Technology registry to assess the impact of reproductive aging on live-birth rate. Fertil Steril 100(1):208–213. doi:10.​1016/​j.​fertnstert.​2013.​02.​055 CrossRefPubMed
34.
Zurück zum Zitat van Rooij IA, Bancsi LF, Broekmans FJ, Looman CW, Habbema JD, te Velde ER (2003) Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization. Fertil Steril 79(3):482–488CrossRefPubMed van Rooij IA, Bancsi LF, Broekmans FJ, Looman CW, Habbema JD, te Velde ER (2003) Women older than 40 years of age and those with elevated follicle-stimulating hormone levels differ in poor response rate and embryo quality in in vitro fertilization. Fertil Steril 79(3):482–488CrossRefPubMed
Metadaten
Titel
Effect of elevated estradiol levels on the hCG administration day on IVF pregnancy and birth outcomes in the long GnRH-agonist protocol: analysis of 3393 cycles
verfasst von
Meimei Wang
Cuifang Hao
Hongchu Bao
Xin Huang
Zhenteng Liu
Wei Zhang
Fenghua Li
Publikationsdatum
17.11.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 2/2017
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-016-4242-3

Weitere Artikel der Ausgabe 2/2017

Archives of Gynecology and Obstetrics 2/2017 Zur Ausgabe

Update Gynäkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.