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Supraphysiological estradiol levels on the hCG trigger day are associated with SGA for singletons born from fresh embryo transfer

Published online by Cambridge University Press:  11 May 2021

Junwei Zhang ,
Mingze Du  and
Lijun Sun Open the ORCID record for Lijun Sun [Opens in a new window]
Junwei Zhang
Affiliation:
The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, 7 Kangfuqian Road, Zhengzhou, 450052, Henan, People’s Republic of China
Mingze Du
Affiliation:
The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, 7 Kangfuqian Road, Zhengzhou, 450052, Henan, People’s Republic of China
Lijun Sun*
Affiliation:
The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, 7 Kangfuqian Road, Zhengzhou, 450052, Henan, People’s Republic of China
*
Address for correspondence: Lijun Sun, The Reproduction Center, The Third Affiliated Hospital of Zhengzhou University, 7 Kangfuqian Road, Zhengzhou, 450052, Henan, People’s Republic of China. Email: [email protected]
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Abstract

The effects of supraphysiological estradiol (E2) on neonatal outcomes and the significance of specific E2 concentrations remain unclear. The purpose of this study was to investigate whether supraphysiological E2 levels on the human chorionic gonadotropin (hCG) trigger day are associated with small size for gestational age (SGA) in singletons born from fresh embryo transfer (ET) cycles. Patients with singleton pregnancies who delivered after the transfer of fresh embryos, during the period from July 2012 to December 2017, at our center were included. We excluded cycles involving a vanishing twin, maternal age >35 years, basal follicle-stimulating hormone ≥10 mIU/ml, or anti-Müllerian hormone ≤1 ng/ml. We then divided all cycles into five groups by E2 level on trigger day: group A, <2000 pg/ml (reference group); group B, 2000 pg/ml≤E2<2999 pg/ml; group C, 3000 pg/ml≤E2<3999 pg/ml; group D, 4000 pg/ml≤E2<4999 pg/ml; and group E, ≥5000 pg/ml. The prevalence of SGA among singletons from fresh ET was the primary outcome. The SGA rate significantly increased when the E2 level was ≥4000 pg/ml, as observed by comparing groups D (odds ratio [OR]: 1·79, 95% confidence interval [CI]: 1·16–2·76, P = 0·01) and E (OR: 1·68, 95% CI: 1·10–2·56, P = 0·02) with the reference group. Multivariate logistic regression indicated that a serum E2 level of at least 4000 pg/ml on the hCG trigger day was associated with increased SGA and with significant differences for groups D (adjusted OR [AOR]: 1·65, 95% CI: 1·05–2·59, P = 0·03) and E (AOR: 1·60, 95% CI: 1·03–2·53, P = 0·04) relative to the reference group. In conclusion, in fresh ET cycles, the supraphysiological E2 ≥4000 pg/ml on the hCG trigger day increases the risk of SGA.

Keywords

Fresh embryo transferserum estradiolsmall for gestational agelow birth weight
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 13 , Issue 2 , April 2022 , pp. 244 - 251
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Copyright
© The Author(s), 2021. Published by Cambridge University Press in association with International Society for Developmental Origins of Health and Disease

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Footnotes

†

The first two authors should be considered similar in author order.

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