Serum estradiol level change after human chorionic gonadotropin administration had no correlation with live birth rate in IVF cycles

Huang, Rui; Fang, Cong; Wang, Ningning; Li, Li-Lin; Yi, Yong; Liang, Xiaoyan

doi:10.1016/j.ejogrb.2014.02.040

Cited by 10 publications

(8 citation statements)

References 28 publications

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“…We also found that serum basal E 2 levels were marginally higher in the NLB group in crude analysis (138.21 ± 90.02 vs 130.14 ± 97.57 pmol/L, P = 0.082), but the difference was not statistically significant. This finding is in accordance with a previous study which reported that serum E 2 had no correlation with LB rate [ 22 ]. Baker et al found a negative association between gonadotropin dose and LB after IVF treatment, which was consistent with our study [ 23 ].…”

Section: Discussionsupporting

confidence: 93%

Factors affecting the live-birth rate in women with diminished ovarian reserve undergoing IVF-ET

Huang

Zhang

et al. 2018

Arch Gynecol Obstet

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PurposeThe occurrence of diminished ovarian reserve (DOR) in women was growing in recent years. Although in vitro fertilization and embryo transfer (IVF-ET) became an effective treatment for DOR, the live-birth (LB) rate remains unsatisfactory. This study aimed to investigate the impact factors of LB rate in women with DOR undergoing assisted reproduction.MethodsThis was a single-center retrospective cohort study. A total of 2277 IVF-ET or ICSI cycles from 1957 DOR women were analysed. Impact factors of LB rate were explored via Student’s t test, Pearson’s Chi-square test, and multivariate logistic regression models.ResultsThere were statistically significant differences in maternal age (P < 0.001), duration of infertility (P < 0.001), female body mass index (P = 0.039), first IVF cycle (P = 0.004), poor ovarian response (P < 0.001), paternal age (P < 0.001), total gonadotropin dose (P = 0.010), endometrial thickness (P = 0.021), number of follicles ≥ 14 mm (P = 0.007), number of oocytes retrieved (P < 0.001), number of frozen embryos (P = 0.014), and the stage (P < 0.001) and number (P < 0.001) of embryos transferred between the non-live-birth (NLB) and LB groups. However, only factors of maternal age, the stage and number of embryos transferred remained different after adjusting for potential confounders.ConclusionsMaternal age, the stage and number of embryos transferred were independent impact factors affecting the live-birth rate in women with DOR seeking for assisted conception.

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Section: Discussionsupporting

confidence: 93%

Factors affecting the live-birth rate in women with diminished ovarian reserve undergoing IVF-ET

Huang

Zhang

et al. 2018

Arch Gynecol Obstet

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“…Some studies [6, 7,13] suggested that the E2 level on the day of hCG trigger affected clinical pregnancy rates. However, most studies [20][21][22] suggested that E2 levels before oocyte retrieval cannot be used as the sole predictor of clinical outcomes. The different conclusions of these studies could also be related to the different research groups and COS protocols.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of Decreased Serum Estradiol Levels Following Human Chorionic Gonadotropin Trigger For Unexpected Ovulation During In Vitro Fertilization Cycle of Patients With Poor Ovarian Response

Huang¹,

Zhang²,

Sun³

et al. 2021

Preprint

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Background Unexpected spontaneous ovulation typically occurs in patients with poor ovarian response (POR); however, reliable predictors are lacking. We analyzed explore the predictive value of decreased serum estradiol (E2) levels on the day after human chorionic gonadotropin (hCG) trigger during in vitro fertilization (IVF) cycles. Methods We retrospectively analyzed clinical data (n = 978) in IVF cycles between 2017 and 2020. According to decreased ratios of E2 levels (△E2%) between day 1 and day 0 of hCG trigger, patients were divided into: ≤10% (group A), 10–20% (group B), and ≥ 20% (group C). Basic characteristics and laboratory data were compared using analysis of variance or Mann–Whitney U-test. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to assess the relationship between △E2% and spontaneous unexpected ovulation. Fresh embryo transfer cycles in groups A, B, and C were subgrouped as A1, B1, and C1, respectively; clinical outcomes were compared. Results Mean E2 and luteinizing hormone (LH) levels, ratio of premature LH peak and high progesterone levels, time interval between hCG trigger and oocyte retrieval, number of follicles ≥ 11 mm in diameter, and dose regimen of gonadotropin among the three groups showed significant differences (P < 0.05). After adjusting for relevant confounders, likelihood ratios of unexpected ovulation in groups B and C were 2.96 (95 % confidence interval [CI]: 0.64–13.70), and 11.74 (95 % CI: 3.09–44.62), respectively, compared with that in group A. The test for trend was significant before and after correction (P for trend < 0.05). On combining premature LH peak (> 10 mIU/mL) or high progesterone level (> 1.0 ng/mL) on the day of hCG, area under ROC curve (AUC) was 0.849 (95 % CI, 0.764–0.934, P < 0.05). However, when we only considered △E2%, AUC was 0.738 (95 % CI. 0.562–0.914, P < 0.05). Rates of embryo implantation, clinical pregnancy, live birth in fresh embryo transfer cycle, and early abortion among the three subgroups did not differ significantly (P > 0.05). Conclusions E2 levels on the day after hCG trigger are valuable for predicting unexpected ovulation. However, their decreased levels do not directly affect clinical pregnancy outcomes.

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“…Her mother and younger sister had a heterozygous mutation of IVS14-1G > G/C in intron 14. All other family members showed no clinical manifestation studies revealed that increasing serum estradiol during ovulation induction was associated with favorable pregnancy outcomes [24,25]. Also, increasing oocyte retrieval and improved embryo quality were reported in IVF cycles with high serum estradiol levels [26,27].…”

Section: Discussionmentioning

confidence: 99%

“…Severe estradiol deficiency might be related to the arrest of follicular growth [30]. However, many retrospective studies failed to show this correlation [24][25][26][27][31][32][33]. They suggested serum estradiol concentration alone near the HCG day being a poor predictor of IVF outcomes.…”

Section: Discussionmentioning

confidence: 99%

Clinical and genetic analysis of cytochrome P450 oxidoreductase (POR) deficiency in a female and the analysis of a novel POR intron mutation causing alternative mRNA splicing

Zhang

Zhou

Ren

et al. 2020

J Assist Reprod Genet

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Objective To characterize the clinical features of a female with P450 oxidoreductase (POR) deficiency and to investigate the underlying mechanisms of POR inactivation. Methods The proband was a 35-year-old woman with primary infertility and menstrual irregularity. The reproductive endocrine profile was evaluated. DNA sequencing was conducted for the identification of POR gene mutation. RT-PCR was performed to confirm the impact of the mutation on POR mRNA. A molecular model was built for the structural analysis of mutant POR protein. ResultsThe evaluation of reproductive endocrine profile revealed elevation of serum follicle-stimulating hormone (11.48 mIU/ ml), progesterone (11.00 ng/ml), 17α-hydroxyprogesterone (24.24 nmol/l), dehydroepiandrosterone (6300 nmol/l), and androstenedione (3.89 nmol/l) and decreased estradiol (36.02 pg/ml). Sequencing of the POR gene showed the female was a compound heterozygote of the paternal P399_E401 deletion and a novel maternal IVS14-1G>C mutation. Functional analysis revealed IVS14-1G>C mutation caused alternative splicing of POR mRNA, with the loss of 12 nucleotides in exon 15 (c.1898_1909delGTCTACGTCCAG). Also, the resulting mutant POR protein had a V603_Q606 deletion, which inactivated the nucleotide-binding domain of NADPH in POR protein (K602_Q606). Conclusion The mutation IVS14-1G>C of the POR gene could cause alternative splicing of POR mRNA and dysfunction of the resulting POR protein. Under proper IVF strategy with glucocorticoid therapy and endometrial preparation, females with mild POR deficiency still have the opportunity to have a live birth.Keywords Cytochrome P450 oxidoreductase deficiency . Live birth . In vitro fertilization . Alternative splicing . Compound heterozygote Précis Clinical and genetic analysis of POR deficiency in a female.

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Serum estradiol level change after human chorionic gonadotropin administration had no correlation with live birth rate in IVF cycles

Cited by 10 publications

References 28 publications

Factors affecting the live-birth rate in women with diminished ovarian reserve undergoing IVF-ET

Factors affecting the live-birth rate in women with diminished ovarian reserve undergoing IVF-ET

Predictive Value of Decreased Serum Estradiol Levels Following Human Chorionic Gonadotropin Trigger For Unexpected Ovulation During In Vitro Fertilization Cycle of Patients With Poor Ovarian Response

Clinical and genetic analysis of cytochrome P450 oxidoreductase (POR) deficiency in a female and the analysis of a novel POR intron mutation causing alternative mRNA splicing

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