摘要
Abstract
Objectives:To analyze the effect of difference between estradiol(E2)level on the day before frozen-thawed embryo transfer(FET)and single follicular E2 level on trigger day during controlled ovulatory cycle on pregnancy outcomes.
Methods:The clinical data of 1 100 patients(1 100 cycles)who underwent FET at the Reproductive Medicine Department of The Affiliated Hospital of Southwest Medical University from October 2018 to December 2023 were analyzed retrospectively.The patients were divided into three groups based on the ratio of the E2 level before FET to single follicular E2 level on trigger day(E2 ratio):＜0.7 for group A with E2 decreased(n=423),0.7 to 1.3 for group B with E2 balanced(n=318),and＞1.3 for group C with E2 increased(n=359).The results of three groups,such as the basic characteristics,ovulation induction and pregnancy outcomes were compared among the three groups.
Results:There were no significant differences in age,antral follicle count,anti-Müllerian hormone level among the three groups(P＞0.05).The E2 level on the day before FET in group A was significantly lower than those in groups B and C,and the single follicular E2 level on trigger day and the endometrial thickness were significantly higher than those of groups B and C(P＜0.05).The clinical pregnancy rate(50.59％)and the live birth rate(42.08％)in group A were significantly lower than those in groups B(62.58％,52.52％,respectively)and C(59.05％,49.86％,respectively,P＜0.05).There were no significant differences in the abortion rate among three groups(P＞0.05).In order to control for interference factors,patients with an E2 range of 367-1 835 pmol/L and endometrial thickness of 9-14 mm on the day before FET were selected for the secondary analysis.The results showed that the live birth rate ingroup A(41.24％)was significantly lower than group B(54.63％,P＜0.05).Logistic regression analysis results of the influence on FET live birth rate showed that the patient age[OR=0.965,95％CI(0.932,0.998)],number of high-quality embryos transplanted[OR=1.625,95％CI(1.251,2.111)],the embryo type transferred[(OR=1.958,95％CI(1.501,2.555)],and the ratio of E2 level on the day before FET to single follicular E2 level on trigger day[OR=1.079,95％CI(1.018,1.143)]were significantly correlated with the live birth rate during FET(P＜0.05).
Conclusions:The difference between E2 level on the day before FET and single follicular E2 level on trigger day is related to the outcomes of FET.When the E2 level on the day before FET decreases more than 30％compared to the single follicular estradiol level on trigger day(E2 ratio＜0.7),it may cause a significant decrease in the live birth rate of the FET cycle.关键词
雌二醇/卵泡/冻融胚胎移植/妊娠结局Key words
Estradiol/Follicle/Frozen-thawed embryo transfer/Pregnancy outcome分类
医药卫生
