title: Effect of elevated estradiol levels on the hCG administration day on IVF pregnancy and birth outcomes in the long GnRH-agonist protocol: analysis of 3393 cycles.
abstract: BACKGROUND
  This retrospective study aimed to evaluate the association between elevated serum estradiol (E2) levels on the human chorionic gonadotrophin (hCG) administration day and in vitro fertilization (IVF) pregnancy and birth outcomes in the long GnRH-agonist protocol.
  
  
  METHODS
  This study analyzed the data of 3393 infertile women who underwent initial fresh IVF. The patients were categorized into high and low E2groups based on their serum E2levels on the hCG day. Pregnancy and birth outcomes were compared.
  
  
  RESULTS
  The implantation rate, clinical pregnancy rate, and live birth rate were all significantly higher in the high E2group than in the low E2group (p < 0.05). The good-quality embryo rate and abortion rate did not significantly differ between the two groups. There were no significant differences in the mode of delivery, gestational age, birth weight, and fetal gender between the two groups. Furthermore, there were no differences in the risk of preterm birth, low birth weight, and fetal malformation between the two groups in 860 single live births. Subgroup analysis of singleton pregnancies in the high E2(E2≥ 3757 pg/mL) group revealed a significant increase in abortion rate in the age group of ≥37 years.
  
  
  CONCLUSIONS
  Elevated serum E2levels associated with controlled ovarian stimulation did not increase the risks of preterm birth, low birth weight, and fetal malformation. High E2on the hCG day had no detrimental effect on the implantation rate, clinical pregnancy rate, and live birth rate.
authors.affiliation: Shandong University School of Medicine, Jinan, People's Republic of China.|Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, 20 Yuhuangding Road East, Yantai, 264000, Shandong, People's Republic of China.
authors.forename: Meimei
authors.initials: M
authors.lastname: Wang
authors.affiliation: Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, 20 Yuhuangding Road East, Yantai, 264000, Shandong, People's Republic of China. wangmeimei76@163.com.
authors.forename: Cuifang
authors.initials: C
authors.lastname: Hao
authors.affiliation: Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, 20 Yuhuangding Road East, Yantai, 264000, Shandong, People's Republic of China.
authors.forename: Hongchu
authors.initials: H
authors.lastname: Bao
authors.affiliation: Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, 20 Yuhuangding Road East, Yantai, 264000, Shandong, People's Republic of China.
authors.forename: Xin
authors.initials: X
authors.lastname: Huang
authors.affiliation: Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, 20 Yuhuangding Road East, Yantai, 264000, Shandong, People's Republic of China.
authors.forename: Zhenteng
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, 20 Yuhuangding Road East, Yantai, 264000, Shandong, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Reproductive Medicine Centre, Yuhuangding Hospital of Yantai, Affiliated Hospital of Qingdao University, 20 Yuhuangding Road East, Yantai, 264000, Shandong, People's Republic of China.
authors.forename: Fenghua
authors.initials: F
authors.lastname: Li
mesh_terms: D000328:Adult; D001723:Birth Rate; D006063:Chorionic Gonadotropin / Q000008:administration & dosage*; D004958:Estradiol / Q000097:blood*; D005260:Female; D005307:Fertilization in Vitro / Q000379:methods*; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D007247:Infertility, Female / Q000628:therapy*; D010062:Ovulation Induction / Q000379:methods; D011247:Pregnancy; D018873:Pregnancy Rate; D012189:Retrospective Studies
chemical_list: D006063:Chorionic Gonadotropin; D007987:Gonadotropin-Releasing Hormone; D004958:Estradiol
keywords: Estradiol; Implantation; In vitro fertilization; Live birth rate; Pregnancy rate