Analysis of the Clinical Outcomes of in Vitro Fertilization-Embryo Transfer Based on Estradiol Level with Humanchorionic Gonadotropin Trigger Day

Shi Zhanrong; Zhao Fang; Zhu Guangli

doi:10.3969/j.issn.1004-5775.2025.06.006

Abstract：Objective:To analyze the effect of estradiol level with humanchorionic gonadotropin(HCG)trigger day on clinical outcome of in vitro fertilization embryo transfer(IVF/ICSI-ET).Methods:The data of patients of 762 cycles who had IVF/ICSI-ET in the Reproductive Medicine Department,Jiaozuo Maternal and Child Health Hospital from January 2019 to July 2022 were analyzed.According to estradiol level with HCG trigger day divided four groups:Group A(n=161)≤2 000pg/ml,Group B(n=220)＞2 000～3 000 pg/ml,Group C(n=189)＞3 000～＜4 000 pg/ml,Group D(n=192)≥4 000 pg/ml.The baisc information and neonatal outcomes among the groups were compared and analyzed.Results:A total of 762 patients(762 cycles)meeting the criteria were included in this study,and In fertilization time and BMI of group A were higher,LH and A MH were higher than the other groups(F=3.465,15.362,7.432,13.676;P＜0.05).The total amount of Gn in group A was higher than that in other groups,the level of LH injected with HCG in group B was higher than that in other groups,the number of Gn days,the level of P injected with HCG,the number of eggs obtained,the number of transferable embryos and the incidence of OHSS in group D were higher than that in other groups(F=6.258,4.585,7.234,77.108,93.649,46.687,13.165;P＜0.05).There were no significant differences in gestational weeks and preterm birth rate among all groups(χ2=1.843,7.140;P＞0.05).Logistic regression analysis showed that age,BMI,Em on HCG injection day and E2≥4 000 pg/mL on HCG injection day had significant effects on LBW and SAG(OR=0.89,0.78,1.88,2.54;0.89,0.93,1.12,1.15;P＜0.05).Conclusion:The optimal clinical pregnancy rate for patients is 2 000～3 000 pg/ml of E2 level on HCG trigger day.The risk of OHSS and LBW and SGA in singleton offspring is significantly increased when the levels exceed 4 000 pg/ml.For such patients,frozen embryo transfer after whole embryo cryopreservation can be considered to reduce the occurrence of these complications.