Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer Cycles

Background: The purpose of this study is to assess the effects of high serum estradiol (E2) levels on reproductive outcomes as well as to compare pregnancy outcomes of duration of vaginal E2 administration after the day of progesterone (P4) initiation in frozen-thawed embryo transfer (FET) hormonal...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiaolei Zhang, Minglei Wang, Yongqian Chen, Linan Li
Format: Article
Language:English
Published: IMR Press 2024-07-01
Series:Clinical and Experimental Obstetrics & Gynecology
Subjects:
Online Access:https://www.imrpress.com/journal/CEOG/51/7/10.31083/j.ceog5107164
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849768461742374912
author Xiaolei Zhang
Minglei Wang
Yongqian Chen
Linan Li
author_facet Xiaolei Zhang
Minglei Wang
Yongqian Chen
Linan Li
author_sort Xiaolei Zhang
collection DOAJ
description Background: The purpose of this study is to assess the effects of high serum estradiol (E2) levels on reproductive outcomes as well as to compare pregnancy outcomes of duration of vaginal E2 administration after the day of progesterone (P4) initiation in frozen-thawed embryo transfer (FET) hormonal replacement cycles. Methods: We performed a retrospective cohort study on 627 patients ≤40 years old that underwent a FET cycle. The patients were grouped based on the serum E2 level on the P4 initiation day as follows: E2 ≤600 pg/mL (n = 471); E2 ≥900 pg/mL (n = 151); the group of E2 600–900 pg/mL (n = 5) was not included in the analysis due to too small sample size. A total of 151 patients with E2 ≥900 pg/mL were grouped based on the duration of vaginal E2 administration after the day of P4 initiation: withdrawal before transfer (n = 53); constant administration (n = 98). Results: There was no significant difference in implantation rate, clinical pregnancy rate, spontaneous abortion rate, premature birth rate, live birth rate and multiple pregnancy rate between the two E2 level groups. The logistic regression analysis demonstrated that age was the only variable that significantly affected clinical pregnancy rate and live birth rate. There were no fetal malformations in either group. Baseline characteristics of patients with different duration of vaginal E2 administration were similar. The pregnancy outcomes showed no significant difference between the withdrawal before transfer group and the constant administration group. Conclusions: In FET cycles, high E2 level on the embryo transfer day did not reduce the clinical pregnancy and live birth rates. In addition, vaginal E2 could be stopped on the embryo transfer day since we found no benefit in continuing E2 until the pregnancy testing day.
format Article
id doaj-art-56b2633be9ef4122894113cf272ea4ac
institution DOAJ
issn 0390-6663
language English
publishDate 2024-07-01
publisher IMR Press
record_format Article
series Clinical and Experimental Obstetrics & Gynecology
spelling doaj-art-56b2633be9ef4122894113cf272ea4ac2025-08-20T03:03:46ZengIMR PressClinical and Experimental Obstetrics & Gynecology0390-66632024-07-0151716410.31083/j.ceog5107164S0390-6663(24)02404-7Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer CyclesXiaolei Zhang0Minglei Wang1Yongqian Chen2Linan Li3Department of Reproductive Medicine, The First Affiliated Hospital of Harbin Medical University, 150000 Harbin, Heilongjiang, ChinaDepartment of Reproductive Medicine, The First Affiliated Hospital of Harbin Medical University, 150000 Harbin, Heilongjiang, ChinaDepartment of Reproductive Medicine, The First Affiliated Hospital of Harbin Medical University, 150000 Harbin, Heilongjiang, ChinaDepartment of Reproductive Medicine, The First Affiliated Hospital of Harbin Medical University, 150000 Harbin, Heilongjiang, ChinaBackground: The purpose of this study is to assess the effects of high serum estradiol (E2) levels on reproductive outcomes as well as to compare pregnancy outcomes of duration of vaginal E2 administration after the day of progesterone (P4) initiation in frozen-thawed embryo transfer (FET) hormonal replacement cycles. Methods: We performed a retrospective cohort study on 627 patients ≤40 years old that underwent a FET cycle. The patients were grouped based on the serum E2 level on the P4 initiation day as follows: E2 ≤600 pg/mL (n = 471); E2 ≥900 pg/mL (n = 151); the group of E2 600–900 pg/mL (n = 5) was not included in the analysis due to too small sample size. A total of 151 patients with E2 ≥900 pg/mL were grouped based on the duration of vaginal E2 administration after the day of P4 initiation: withdrawal before transfer (n = 53); constant administration (n = 98). Results: There was no significant difference in implantation rate, clinical pregnancy rate, spontaneous abortion rate, premature birth rate, live birth rate and multiple pregnancy rate between the two E2 level groups. The logistic regression analysis demonstrated that age was the only variable that significantly affected clinical pregnancy rate and live birth rate. There were no fetal malformations in either group. Baseline characteristics of patients with different duration of vaginal E2 administration were similar. The pregnancy outcomes showed no significant difference between the withdrawal before transfer group and the constant administration group. Conclusions: In FET cycles, high E2 level on the embryo transfer day did not reduce the clinical pregnancy and live birth rates. In addition, vaginal E2 could be stopped on the embryo transfer day since we found no benefit in continuing E2 until the pregnancy testing day.https://www.imrpress.com/journal/CEOG/51/7/10.31083/j.ceog5107164embryo transfercryopreservationestradiolpregnancy outcomelive birth
spellingShingle Xiaolei Zhang
Minglei Wang
Yongqian Chen
Linan Li
Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer Cycles
Clinical and Experimental Obstetrics & Gynecology
embryo transfer
cryopreservation
estradiol
pregnancy outcome
live birth
title Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer Cycles
title_full Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer Cycles
title_fullStr Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer Cycles
title_full_unstemmed Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer Cycles
title_short Effect of High Serum Estradiol Levels and Duration of Vaginal Estradiol Administration on Reproductive Outcomes in Frozen-Thawed Embryo Transfer Cycles
title_sort effect of high serum estradiol levels and duration of vaginal estradiol administration on reproductive outcomes in frozen thawed embryo transfer cycles
topic embryo transfer
cryopreservation
estradiol
pregnancy outcome
live birth
url https://www.imrpress.com/journal/CEOG/51/7/10.31083/j.ceog5107164
work_keys_str_mv AT xiaoleizhang effectofhighserumestradiollevelsanddurationofvaginalestradioladministrationonreproductiveoutcomesinfrozenthawedembryotransfercycles
AT mingleiwang effectofhighserumestradiollevelsanddurationofvaginalestradioladministrationonreproductiveoutcomesinfrozenthawedembryotransfercycles
AT yongqianchen effectofhighserumestradiollevelsanddurationofvaginalestradioladministrationonreproductiveoutcomesinfrozenthawedembryotransfercycles
AT linanli effectofhighserumestradiollevelsanddurationofvaginalestradioladministrationonreproductiveoutcomesinfrozenthawedembryotransfercycles