Supraphysiological estradiol level in ovarian stimulation cycles affects the birthweight of neonates conceived through subsequent frozen‐thawed cycles: a retrospective study. (21st February 2019)

• Record Type: Journal Article
• Authors: Cai, J; Liu, L; Xu, Y; Liu, Z; Jiang, X; Li, P; Sha, A; Ren, J
• Is Part Of: BJOG. Volume 126:Number 6(2019)
• Page Start: 711
• Page End: 718
• Publication Date: 2019-02-21
• Subjects: Birthweight -- estrogen -- frozen‐thawed embryo transfer -- ovarian stimulation -- small for gestational age; Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1111/1471-0528.15606
• Languages: English
• ISSNs: 1470-0328

Abstract

Abstract : Objective: To investigate whether supraphysiological estradiol (E2 ) in controlled ovarian stimulation (COS) cycles affects the subsequent frozen‐thawed embryo transfer (FET) in terms of the neonatal birthweight. Design: Retrospective cohort study. Setting: University affiliated hospital. Population: In all, 2066 patients undergoing FET cycles that resulted in live singleton births between July 2011 and Dec 2016. Interventions: None. Methods: Multivariable linear regression and logistic regression was used to evaluate the association between peak E2 and birthweight outcomes. Main outcome measures: Birthweight, z ‐score adjusted for gender and gestational age, and incidence of small‐for‐gestational‐age (SGA) and low birthweight (LBW) in singleton neonates derived from FET cycles. Results: Adjusted for confounding factors, both the absolute birthweight and the z ‐score of singletons following FET were negatively associated with peak E2 levels in COS. In comparison with the referent category (E2 ≤1500 pg/ml), the categories with E2 >3000 pg/ml had a significantly lower z ‐score. The difference (95% CI) in estimated marginal mean of birthweights between referent category and highest E2 (>8000 pg/ml) category was 104.57 g (18.13–181.06). Multiple logistic regression analyses showed that the adjusted odds ratio (95% CI) for SGA and LBW in term singletons comparing patients with E2 >3000 pg/ml with those with E2 ≤3000 pg/ml was 2.44 (1.37–4.34) and 2.32 (1.01–5.40), respectively. Conclusions: Peak E2 levels in COS cycles are negatively associated with the birthweight of singletons conceived through subsequent FET cycles. Tweetable abstract: The birthweight following FET is affected by previous COS cycle. Tweetable abstract: The birthweight following FET is affected by previous COS cycle.