冻融胚胎移植周期内膜转化前血清高雌二醇水平不影响妊娠结局

Effect of serum estradiol level before progesterone administration on pregnancy outcomes of frozen-thawed embryo transfer cycles

目的探讨冻融胚胎移植(FET)周期血清高雌二醇(E2)水平是否对妊娠结局有负面影响。方法回顾性分析2017年2月~8月于本中心行激素替代治疗(HRT)-FET的205个周期,根据内膜转化前E2水平分为高E2组(E2>600 pg/m L,45例)和对照组(E2≤600 pg/m L,160例)。比较两组的基本特征和妊娠结局。结果两组在对应取卵周期时的年龄、BMI、FET日内膜厚度等方面的差异无统计学意义(P>0.05)。高E2组FET时的年龄小于对照组、雌激素使用天数大于对照组,且差异均具统计学意义(P<0.05)。两组的临床妊娠率、继续妊娠率、早期流产率、晚期流产率及活产率之间的差异无统计学意义(P>0.05),且在控制FET时的年龄和雌激素使用天数等混杂因素后,两组间妊娠结局的差异亦无统计学意义。结论 HRT-FET周期内膜转化前血清高E2水平不影响妊娠结局。

Objective To explore whether a high serum estradiol（E2） level before progesterone administration adversely affects the pregnancy outcomes of frozen-thawed embryo transfer（FET） cycles. Methods We retrospectively analyzed 205 hormone replacement therapy（HRT）-FET cycles in our Center between February, 2017 and August, 2017. With a cutoff value of serum E2 level of 600 pg/m L before progesterone administration, the cases were divided into high E2 level group and control group with normal E2 level, and the clinical characteristics and pregnancy outcomes were compared between the two groups. Results No significant difference was found between the two groups in the patients＇ age during IVF/ICSI cycle, body mass index（BMI） or endometrial thickness at the time of FET（P〉0.05）. The patients with high E2 levels had a significantly younger age（P〈0.05） and a significantly longer duration of estradiol administration than those in the control group（P〈0.05）. The clinical pregnancy rates, ongoing pregnancy rates, early miscarriage rates, late abortion rates and live birth rates were all comparable between the two groups（P〉0.05）. After controlling for the compounding factors including the age at FET cycle and the duration of estradiol administration, all these pregnancy outcomes were still comparable between the two groups. Conclusion A high serum E2 level before progesterone administration does not adversely affect the pregnancy outcomes of HRT-FET cycles.