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Journal of Assisted Reproduction and Genetics

Erschienen in:

01.01.2014 | Assisted Reproduction Technologies

The impact of supraphysiologic serum estradiol levels on peri-implantation embryo development and early pregnancy outcome following in vitro fertilization cycles

verfasst von: Anthony N. Imudia, Randi H. Goldman, Awoniyi O. Awonuga, Diane L. Wright, Aaron K. Styer, Thomas L. Toth

Erschienen in: Journal of Assisted Reproduction and Genetics | Ausgabe 1/2014

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Abstract

Purpose

To determine the impact of elevated serum estradiol levels (EE₂-defined as levels > 90th percentile) on the day of hCG administration during IVF on oocyte fertilization, embryo development, implantation, clinical pregnancy and miscarriage rates.

Methods

A total of 2,995 consecutive IVF cycles in 1,889 patients with non-donor oocyte retrieval resulting in fresh embryo transfer between 1/1/2005 and 12/31/2011 were analyzed. Cycles were stratified by serum E₂ level on the day of hCG administration into those with levels >90th percentile and ≤ 90th percentile. Rates of normal fertilization, embryo development, positive pregnancy test, implantation, clinical pregnancy and spontaneous miscarriage were compared.

Results

Serum estradiol above the 90th percentile on the day of hCG administration was associated with a significantly lower rate of normal fertilization (68.6 ± 20 vs. 71.6 ± 21, p = 0.02) when compared with patients with a lower serum estradiol threshold. The proportion of embryos that progressed from 2PN to 6–8 cell on day 3 was not different between the two groups. Although rates of positive pregnancy test (55.2 % vs. 57 %), implantation (26.4 % vs. 28.5 %) and clinical pregnancy (45.5 % vs. 49.4 %) were lower in patients with a higher estradiol threshold, these differences were not statistically significant. Similarly, there was no difference in the spontaneous miscarriage rates between the two groups (8.4 % vs. 7.1 %).

Conclusions

Serum estradiol levels above the 90th percentile on the day of hCG administration is associated with lower oocyte fertilization rate; however, such levels do not impact embryo development, implantation, clinical pregnancy or spontaneous miscarriage rates.

Allen VM, Wilson RD, Cheung A. Pregnancy outcomes after assisted reproductive technology. J Obstet Gynaecol Can. 2006;28:220–50.PubMed

Bohlmann MK, Fritzsching B, Luedders DW, Hornemann A, Gopel W, Poschl J, et al. Impact of assisted reproduction on obstetrics and neonatology. Z Geburtshilfe Neonatol. 2009;213:221–7.PubMedCrossRef

Davies MJ, Moore VM, Willson KJ, Van Essen P, Priest K, Scott H, et al. Reproductive technologies and the risk of birth defects. New Engl J Med. 2012;366:1803–13.PubMedCrossRef

Gelbaya TA. Short and long-term risks to women who conceive through in vitro fertilization. Hum Fertil (Camb). 2010;13:19–27.CrossRef

Jackson RA, Gibson KA, Wu YW, Croughan MS. Perinatal outcomes in singletons following in vitro fertilization: a meta-analysis. Obstet Gynecol. 2004;103:551–63.PubMedCrossRef

McDonald SD, Han Z, Mulla S, Murphy KE, Beyene J, Ohlsson A. Preterm birth and low birth weight among in vitro fertilization singletons: a systematic review and meta-analyses. Eur J Obstet Gynecol Reprod Biol. 2009;146:138–48.PubMedCrossRef

Perri T, Chen R, Yoeli R, Merlob P, Orvieto R, Shalev Y, et al. Are singleton assisted reproductive technology pregnancies at risk of prematurity? J Assist Reprod Genet. 2001;18:245–9.PubMedCrossRef

Retzloff MG, Hornstein MD. Is intracytoplasmic sperm injection safe? Fertil Steril. 2003;80:851–9.PubMedCrossRef

Schieve LA, Meikle SF, Ferre C, Peterson HB, Jeng G, Wilcox LS. Low and very low birth weight in infants conceived with use of assisted reproductive technology. New Engl J Med. 2002;346:731–7.PubMedCrossRef

10.

Tan SL, Doyle P, Campbell S, Beral V, Rizk B, Brinsden P, et al. Obstetric outcome of in vitro fertilization pregnancies compared with normally conceived pregnancies. Am J Obstet Gynecol. 1992;167:778–84.PubMedCrossRef

11.

Calhoun KC, Barnhart KT, Elovitz MA, Srinivas SK. Evaluating the association between assisted conception and the severity of preeclampsia. ISRN Obstet Gynecol. 2011;2011:928592.PubMedCentralPubMedCrossRef

12.

Farhi J, Ben-Haroush A, Andrawus N, Pinkas H, Sapir O, Fisch B, et al. High serum oestradiol concentrations in IVF cycles increase the risk of pregnancy complications related to abnormal placentation. Reprod Biomed Online. 2010;21:331–7.PubMedCrossRef

13.

Imudia AN, Awonuga AO, Doyle JO, Kaimal AJ, Wright DL, Toth TL, et al. 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. 2012;97:1374–9.PubMedCrossRef

14.

Barker DJ. In utero programming of chronic disease. Clin Sci (Lond). 1998;95:115–28.CrossRef

15.

Chen QJ, Sun XX, Li L, Gao XH, Wu Y, Gemzell-Danielsson K, et al. Effects of ovarian high response on implantation and pregnancy outcome during controlled ovarian hyperstimulation (with GnRH agonist and rFSH). Acta Obstet Gynecol Scand. 2007;86:849–54.PubMedCrossRef

16.

Forman R, Fries N, Testart J, Belaisch-Allart J, Hazout A, Frydman R. Evidence for an adverse effect of elevated serum estradiol concentrations on embryo implantation. Fertil Steril. 1988;49:118–22.PubMed

17.

O’Neill C, Ferrier AJ, Vaughan J, Sinosich MJ, Saunders DM. Causes of implantation failure after in-vitro fertilisation and embryo transfer. Lancet. 1985;2:615.PubMedCrossRef

18.

Pellicer A, Valbuena D, Cano F, Remohi J, Simon C. Lower implantation rates in high responders: evidence for an altered endocrine milieu during the preimplantation period. Fertil Steril. 1996;65:1190–5.PubMed

19.

Chen QJ, Sun XX, Li L, Gao XH, Gemzell-Danielsson K, Cheng LN. Effects of ovarian stimulation on endometrial integrin beta3 and leukemia inhibitory factor expression in the peri-implantation phase. Fertil Steril. 2008;89:1357–63.PubMedCrossRef

20.

Gelety TJ, Buyalos RP. The influence of supraphysiologic estradiol levels on human nidation. J Assist Reprod Genet. 1995;12:406–12.PubMedCrossRef

21.

Gratton RJ, Nisker JA, Daniel S, Toth S, Gunter J, Kaplan BR, et al. An aggressive philosophy in controlled ovarian stimulation cycles increases pregnancy rates. Hum Reprod. 1993;8:528–31.PubMed

22.

Levi AJ, Drews MR, Bergh PA, Miller BT, Scott Jr RT. Controlled ovarian hyperstimulation does not adversely affect endometrial receptivity in in vitro fertilization cycles. Fertil Steril. 2001;76:670–4.PubMedCrossRef

23.

Simon C, Cano F, Valbuena D, Remohi J, Pellicer A. Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Hum Reprod. 1995;10:2432–7.PubMedCrossRef

24.

Sharara FI, McClamrock HD. High estradiol levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril. 1999;72:401–5.PubMedCrossRef

25.

Tarin JJ, Sampaio MC, Calatayud C, Castellvi RM, Bonilla-Musoles F, Pellicer A. Relativity of the concept ‘high responder to gonadotrophins’. Hum Reprod. 1992;7:19–22.PubMedCrossRef

26.

Ehrlich S, Williams PL, Missmer SA, Flaws JA, Ye X, Calafat AM, et al. Urinary bisphenol A concentrations and early reproductive health outcomes among women undergoing IVF. Hum Reprod. 2012;27:3583–92.PubMedCrossRef

27.

Styer AK, Wright DL, Wolkovich AM, Veiga C, Toth TL. Single-blastocyst transfer decreases twin gestation without affecting pregnancy outcome. Fertil Steril. 2008;89:1702–8.PubMedCrossRef

28.

Pellicer A, Ruiz A, Castellvi RM, Calatayud C, Ruiz M, Tarin JJ, et al. Is the retrieval of high numbers of oocytes desirable in patients treated with gonadotrophin-releasing hormone analogues (GnRHa) and gonadotrophins? Hum Reprod. 1989;4:536–40.PubMed

29.

Tarin JJ, Pellicer A. Consequences of high ovarian response to gonadotropins: a cytogenetic analysis of unfertilized human oocytes. Fertil Steril. 1990;54:665–70.PubMed

30.

Testart J, Belaisch-Allart J, Forman R, Gazengel A, Strubb N, Hazout A, et al. Influence of different stimulation treatments on oocyte characteristics and in-vitro fertilizing ability. Hum Reprod. 1989;4:192–7.PubMed

31.

Testart J, Forman R, Belaisch-Allart J, Volante M, Hazout A, Strubb N, et al. Embryo quality and uterine receptivity in in-vitro fertilization cycles with or without agonists of gonadotrophin-releasing hormone. Hum Reprod. 1989;4:198–201.PubMed

32.

Harrod SB, Lacy RT, Morgan AJ. Offspring of prenatal IV nicotine exposure exhibit increased sensitivity to the reinforcing effects of methamphetamine. Front Pharmacol. 2012;3:116.PubMedCentralPubMedCrossRef

33.

Lee DH, Steffes MW, Sjodin A, Jones RS, Needham LL, et al. Low dose organochlorine pesticides and polychlorinated biphenyls predict obesity, dyslipidemia, and insulin resistance among people free of diabetes. PLoS One. 2011;6:e15997.CrossRef

34.

Turer AT, Mahaffey KW, Honeycutt E, Tuttle RH, Shaw LK, et al. Influence of body mass index on the efficacy of revascularization in patients with coronary artery disease. J Thorac Cardiovasc Surg. 2009;137:1468–74.PubMedCrossRef

35.

Chenette PE, Sauer MV, Paulson RJ. Very high serum estradiol levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril. 1990;54:858–63.PubMed

36.

Chen CH, Zhang X, Barnes R, Confino E, Milad M, Puscheck E, et al. 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. 2003;80:75–9.PubMedCrossRef

Titel: The impact of supraphysiologic serum estradiol levels on peri-implantation embryo development and early pregnancy outcome following in vitro fertilization cycles
verfasst von: Anthony N. Imudia
Randi H. Goldman
Awoniyi O. Awonuga
Diane L. Wright
Aaron K. Styer
Thomas L. Toth
Publikationsdatum: 01.01.2014
Verlag: Springer US
Erschienen in: Journal of Assisted Reproduction and Genetics / Ausgabe 1/2014
Print ISSN: 1058-0468
Elektronische ISSN: 1573-7330
DOI: https://doi.org/10.1007/s10815-013-0117-8

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The impact of supraphysiologic serum estradiol levels on peri-implantation embryo development and early pregnancy outcome following in vitro fertilization cycles