Introduction
Materials and methods
Study subjects and protocol
Ovarian stimulation protocol
Calculation of serum E2
Pregnancy outcomes
Statistical analysis
Results
Study population
Parameter | CCPR positive | CCPR negative | P-Value | CLBR positive | CLBR negative | P-Value |
---|---|---|---|---|---|---|
Number of cycles | 160 | 175 | 124 | 211 | ||
Age, years | 31 (29, 33) | 33 (30, 36) | 0.001* | 31 (29, 33) | 32 (30, 36) | 0.006* |
BMI, kg/m2 | 23.3 (20.7, 26.2) | 23.3 (20.7,26.8) | 0.880 | 22.5 (20.5, 26.3) | 23.4(20.8,26.5) | 0.347 |
Duration of infertility, years | 3(2, 5) | 3(2, 5) | 0.651 | 3(2, 4.5) | 3(2, 5) | 0.580 |
Gn days | 10(9, 11) | 10(9, 11) | 0.622 | 10(9, 11) | 9(9, 11) | 0.773 |
Gn dosage, IU | 2025(1594, 2437) | 2250 (1800,2968) | 0.001* | 2022(1575, 2437) | 2212(1725,2875) | 0.005* |
Number of embryo transfers | 2 (1, 3) | 2 (1, 2) | 0.146 | 2 (1, 3) | 2 (1, 2) | 0.158 |
Baseline FSH, IU/L | 7.29(6.30, 8.67) | 7.66 (6.26, 10) | 0.102 | 7.49(6.20, 8.66) | 7.40 (6.32, 9.89) | 0.522 |
Baseline LH, IU/L | 4.88 (3.78, 7.70) | 4.58(3.44, 5.71) | 0.246 | 5.00 (3.53, 7.05) | 4.73(3.50, 6.54) | 0.316 |
Baseline E2, pg/mL | 40.00(30.00, 55.00) | 45.00(32.00, 59.00) | 0.134 | 40.00(30.00, 54.50) | 44.00(31.50, 59.00) | 0.122 |
AFC | 33.00(23.00,46.00) | 22.00(15.00,32.00) | < 0.001* | 30.00(22.00,43.00) | 24.00(17.00,46.00) | 0.001* |
endometrial thickness, mm | 11.05 (9.80, 12.58) | 11.00 (9.82, 12.50) | 0.929 | 11.20 (9.68, 12.93) | 11.00 (9.98, 12.50) | 0.570 |
Number of oocytes | 12(9,20) | 9(5, 14) | < 0.001* | 13(9,19.5) | 10(6, 14) | < 0.001* |
Number of fertilization | 7 (4, 11) | 5 (2, 9) | < 0.001* | 7 (4, 11) | 5 (2, 9) | < 0.001* |
Number of blastomere | 6 (4, 10) | 4 (2, 8) | < 0.001* | 6 (4, 10) | 5 (2, 8) | < 0.001* |
Number of embryos | 4 (3, 6) | 2(1, 4) | < 0.001* | 4(3, 6) | 2(2, 4) | < 0.001* |
Number of high-quality embryos | 1(0, 2) | 0 (0, 1) | < 0.001* | 1(0, 3) | 0 (0, 1) | < 0.001* |
Baseline characteristics
Serum estradiol levels and ratios of CCPR and CLBR
CCPR positive | CCPR negative | P-Value | CLBR positive | CLBR negative | P-Value | |
---|---|---|---|---|---|---|
E2(Gn1), pg/mL | 40(30, 55) | 45(32, 59) | 0.134 | 40(30, 54.5) | 44(31.5, 59) | 0.122 |
E2(Gn5), pg/mL | 572.00(308, 1067.5) | 447(246.5, 782) | 0.029* | 594 (321,1025) | 448(246.5, 6796.5) | 0.042* |
E2(Gn8), pg/mL | 1889(1089,3452) | 1315(734.5, 2038) | < 0.001* | 1889(1093,3280) | 1432(785.5, 2281) | 0.001* |
E2(HCG), pg/mL | 4139(2243.5, 5010) | 2720(1552, 4775) | < 0.001* | 4166(2243,4996) | 2796(1646, 4800) | 0.002* |
E2 ratio of Gn5/Gn1 | 12.2(7.38, 28.97) | 9.88(5.41, 17.52) | 0.004* | 12.93(7.44, 28.92) | 9.96(5.59, 18.9) | 0.006* |
E2 ratio of Gn8/Gn5 | 3.14(2.6, 3.99) | 2.83(2.14, 3.73) | 0.001* | 3.24(2.63, 4.05) | 2.87(2.27, 3.75) | 0.002* |
E2 ratio of HCG/Gn1 | 86.38(47.05, 129.7) | 58.76(31.93, 100.6) | < 0.001* | 87.22(47.48, 131.48) | 59.73(34.47, 102.12) | < 0.001* |
E2 ratio of HCG/Gn5 | 5.43(3.3, 8.29) | 4.93(3.17, 8.63) | 0.514 | 5.64(3.32,8.39) | 4.99(3.22, 8.44) | 0.562 |
E2 ratio of HCG/Gn8 | 1.57(1.15, 2.33) | 1.70(1.14, 2.64) | 0.113 | 1.62(1.18, 2.39) | 1.66(1.13, 2.54) | 0.245 |
Parameters of different serum estradiol ratios
A1 | A2 | A3 | A4 | P-Value | B1 | B2 | B3 | B4 | P-Value | |
---|---|---|---|---|---|---|---|---|---|---|
Number of cycles | 84 | 84 | 84 | 83 | 84 | 84 | 84 | 83 | ||
Age, years | 32(29,34) | 31.5(29,34) | 31(30,35) | 33(30,35) | 0.61 | 33(30,36) | 32(30,35) | 32(29,34) | 31(29,33) | 0.044* |
BMI, kg/m2 | 22.60(20.70,26.20) | 23.05(20.40,26.40) | 23.40(20.40,27.00) | 24.00(21.70,27.30) | 0.41 | 25.40(22.00,29.05) | 22.80(21.35,25.85) | 22.20(20.20,26.20) | 23.25(20.40,26.00) | 0.002* |
Duration of infertility, years | 3(2,4) | 3(1,5) | 3(2,5) | 3(1,5) | 0.59 | 4(2,6) | 3(2,4.5) | 3(2,4) | 3(1.5,4) | 0.01* |
Gn days | 11(10,12) | 10(9,11) | 9(8,10) | 9(8,10) | < 0.001* | 9(8,10) | 9(9,11) | 10(9,11) | 10.5(10,11) | < 0.001* |
Gn dosage, IU | 2700(2250,3300) | 2250(1725,2625) | 2025(1725,2400) | 1770(1500,2100) | < 0.001* | 1900(1500,2400) | 2175(1812,2700) | 2175(1650,2550) | 2370(1975,2910) | 0.004* |
endometrial thickness, mm | 10.50(9.30, 12.30) | 11.05(9.55, 12.90) | 11.00(9.65, 12.70) | 11.50(10.50, 12.50) | 0.102 | 11.00(9.80, 12.40) | 10.90(10.00, 12.30) | 11.20(10.20, 12.50) | 11.40 (9.40, 12.90) | 0.879 |
Number of eggs | 8(4,12) | 10(6,15) | 10(8,16) | 16(12,23) | < 0.001* | 9(5,14.5) | 11(6,16) | 10(8,14) | 14.5(10,20.5) | < 0.001* |
Number of fertilizatin | 4(2,7) | 6(3,9) | 6.5(4,11) | 8(6,13) | < 0.001* | 5(2,8) | 6(3,9) | 6(4,9) | 8(6,13) | < 0.001* |
Number of blastomere | 3(2,6) | 5(3,8) | 6(4,10) | 7(5,12) | < 0.001* | 4(2,7) | 5(3,8.5) | 5(3,8) | 7(4,11) | 0.002* |
Number of embryos | 2(1,4) | 4(2,6) | 4(2,6) | 5(3,8) | < 0.001* | 3(2,5) | 3(2,5.5) | 4(2,6) | 4(2,6.5) | 0.005* |
Number of high-quality embryos | 0(0,1) | 1(0,2) | 1(0,2) | 1.5(0,3) | < 0.001* | 1(0,2) | 1(0,1) | 1(0,3) | 1.5(0,3) | 0.03* |
CCPR | 32/84(38.1%)a | 40/84(47.6%) | 38/84(45.2%) | 50/83(60.2%) | 0.036*a | 30/84(35.7%)c | 36/84(42.9%) | 47/84(56.0%) | 47/83(56.6%) | 0.014*c |
CLBR | 21/84(25.0%)b | 33/84(39.3%) | 32/84(38.1%) | 38/83(45.8%) | 0.043*b | 22/84(26.2%)d | 26/84(31.0%) | 39/84(46.4%) | 37/83(44.6%) | 0.013*d |
E2 ratio of Gn5/Gn1 | – | – | – | – | 15.28(7.36,32.33) | 12.85(7.85,25.94) | 9.40(5.12,17.43) | 9.19(5.67,14.91) | < 0.001* | |
E2 ratio of Gn8/Gn5 | 3.28(2.70,4.04) | 3.15(2.32,4.18) | 3.12(2.55,4.08) | 2.70(2.08,3.15) | < 0.001* | – | – | – | – | |
E2(HCG), pg/mL | 2166(1148,3616) | 2592(1589,4800) | 3176(2197,4800) | 4870(3904,5010) | < 0.001* | 2251(1277,4800) | 3212(1895,4870) | 2989(1920,4800) | 4410(2758,5010) | < 0.001* |
Serum estradiol ratio of different ages
P-Value (Age, years < 35) | P-Value (Age, years ≥ 35) | |||||||
---|---|---|---|---|---|---|---|---|
Number of eggs | Number of high-quality embryos | CCPR | CLBR | Number of eggs | Number of high-quality embryos | CCPR | CLBR | |
E2 ratio of Gn5/Gn1 | < 0.001* | < 0.001* | 0.413 | 0.404 | < 0.001* | < 0.001* | 0.467 | 0.149 |
E2 ratio of Gn8/Gn5 | 0.002* | 0.004* | 0.004* | < 0.001* | < 0.001* | < 0.001* | 0.653 | 0.207 |
E2 ratio of HCG/Gn1 | < 0.001* | < 0.001* | < 0.001* | < 0.001* | < 0.001* | < 0.001* | 0.008* | < 0.001* |
Serum estradiol ratio of different infertility factors
A | χ2 | P | B | χ2 | P | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
A1 | A2 | A3 | A4 | B1 | B2 | B3 | B4 | |||||
Tubal factors | 60 | 66 | 54 | 51 | 16.788 | 0.158 | 56 | 59 | 64 | 52 | 10.625 | 0.561 |
Ovulation disorders | 13 | 13 | 18 | 20 | 16 | 17 | 9 | 22 | ||||
Male factors | 9 | 5 | 7 | 6 | 7 | 5 | 7 | 8 | ||||
Pelvic endometriosis | 1 | 0 | 3 | 1 | 2 | 1 | 2 | 0 | ||||
Other factors | 1 | 0 | 2 | 5 | 3 | 2 | 2 | 1 |
Estradiol levels and ratios of different ovarian responses
Low ovarian response | Normal ovarian response | High ovarian response | |||||||
---|---|---|---|---|---|---|---|---|---|
CLBR positive | CLBR negative | P-Value | CLBR positive | CLBR negative | P-Value | CLBR positive | CLBR negative | P-Value | |
E2(Gn1), pg/mL | 40(22,52) | 48(37,63) | 0.081 | 42(30,58) | 42(28.5,57) | 0.763 | 38.54(31,49) | 44(26.15,53) | 0.024 |
E2(Gn5), pg/mL | 260(214,297) | 305(210,440) | 0.131 | 572(324,917) | 519(350,1033.5) | 0.843 | 681(406,1468) | 913(562,1637) | 0.014* |
E2(Gn8), pg/mL | 708(589,1111) | 797(541,1137) | 0.702 | 1780(1100,2917) | 1697(1187,2490) | 0.781 | 3338(1889,4800) | 3854(2115,4800) | 0.343 |
E2(HCG), pg/mL | 1263(928,1898) | 1283(970,1650) | 0.924 | 3887(2219,4982) | 3867(2619,4870) | 0.956 | 4870(4525,5010) | 5010(4800,5010) | < 0.001* |
E2 ratio of Gn5/Gn1 | 7.82(3.72,12.33) | 6.07(4.22,9.18) | 0.45 | 12.64(8.02,24.33) | 11.30(7.37,23.19) | 0.441 | 19.8(10.5,38.12) | 23.35(9.35,38.1) | 0.491 |
E2 ratio of Gn8/Gn5 | 3.06(2.92,3.58) | 2.6(2.08,2.95) | < 0.001* | 3.33(2.65,3.84) | 3.11(2.55,3.83) | 0.017* | 3.43(2.77,5.02) | 3.54(2.32,4.38) | 0.004* |
Effects of estradiol ratios on IVF-ET outcome
95% CI | 95% CI | |||||||||
---|---|---|---|---|---|---|---|---|---|---|
Dependent variable: CCPR | P-Value | OR | Lower | Upper | Dependent variable: CLBR | P-Value | OR | Lower | Upper | |
Independent variables | Independent variables | |||||||||
A | 0.043* | A | 0.099 | |||||||
A1 | 0.008* | 0.376 | 0.182 | 0.779 | A1 | 0.018* | 0.401 | 0.188 | 0.857 | |
A2 | 0.299 | 0.699 | 0.356 | 1.374 | A2 | 0.557 | 0.816 | 0.414 | 1.609 | |
A3 | 0.040* | 0.495 | 0.253 | 0.969 | A3 | 0.207 | 0.647 | 0.329 | 1.272 | |
B | 0.013* | B | 0.015* | |||||||
B1 | 0.005* | 0.363 | 0.179 | 0.735 | B1 | 0.011* | 0.389 | 0.187 | 0.808 | |
B2 | 0.086 | 0.559 | 0.287 | 1.086 | B2 | 0.067 | 0.526 | 0.265 | 1.047 | |
B3 | 0.911 | 0.964 | 0.504 | 1.842 | B3 | 0.860 | 1.060 | 0.556 | 2.021 |