Correlation between Changes in Serum Progesterone and Estradiol Expression on the Day of Frozen Embryo Transfer and Pregnancy Outcomes of Frozen Embryo Transfer in Infertile Patients with Polycystic Ovary Syndrome

LI Xiaohong; JING Xia; WANG Xuesong

doi:10.3639/j.issn.2095-3097.2025.06.017

Abstract：Objective To investigate the correlation between serum progesterone(P)and estradiol(E2)levels on the day of frozen embryo transfer(FET)and the pregnancy outcome of FET in infertile patients with polycystic ovary syndrome(PCOS).Methods A total of 150 infertile patients with PCOS who underwent hormone replacement therapy for endometrial preparation and FET at Yuncheng Central Hospital affiliated to Shanxi Medical University between May 2019 and May 2024 were selected as the research subjects.Clinical data were collected for all patients.Serum levels of P,E2,and 25-hydroxyvitamin D[25-(OH)D],and endometrial thickness were measured on the transfer day.Based on pregnancy status 35 days after transfer,patients were di-vided into a clinical pregnancy group(89 cases)and a non-pregnancy group(61 cases).Eighty-seven clinically pregnant patients completed follow-up.According to the occurrence of adverse events during follow-up,they were divided into a good pregnancy outcome group(50 cases)and a poor pregnancy outcome group(37 cases).Differences in general clinical data,P,E2,and endo-metrial thickness were compared between the clinical pregnancy group and non-pregnancy group,and between the good preg-nancy outcome group and poor pregnancy outcome group.Logistic regression analysis was used to assess the correlation between serum P,E2 levels and clinical pregnancy/pregnancy outcomes.The area under the receiver operating characteristic(ROC)curve(AUC)was used to evaluate the predictive value of serum P and E2 levels on transfer day for FET clinical pregnancy and preg-nancy outcomes in PCOS infertility patients.Results All 150 infertile patients with PCOS completed FET,with 89 successful pregnancies,yielding a clinical pregnancy rate of 59.33%.Multivariate Logistic regression analysis showed that age,body mass index,number of intact blastocyst embryos,25-(OH)D,P,E2,and endometrial thickness were influencing factors for FET clinical pregnancy(OR=1.331,95%CI:1.239-1.418,P<0.001;OR=1.379,95%CI:1.262-1.506,P<0.001;OR=0.472,95%CI:0.350-0.637,P<0.001;OR=0.908,95%CI:0.836-0.985,P=0.002;OR=1.096,95%CI:1.008-1.193,P=0.003;OR=0.712,95%CI:0.606-0.839,P<0.001;OR=0.310,95%CI:0.232-0.411,P<0.001).Eighty-seven clinically pregnant patients completed fol-low-up,with 37 cases(42.53%)of adverse pregnancy outcomes and 50 cases(57.47%)of good pregnancy outcomes.Multivariate Logistic regression analysis showed that age,E2,and endometrial thickness were influencing factors for FET pregnancy outcomes(OR=1.257,95%CI:1.149-1.376,P<0.001;OR=0.954,95%CI:0.930-0.979,P<0.001;OR=2.889,95%CI:2.003-4.168,P<0.001).ROC curve analysis showed that the AUC for P and E2 in predicting FET clinical pregnancy in PCOS infertility patients were 0.805 and 0.723,respectively.The AUC for E2 in predicting FET pregnancy outcomes in PCOS infertility patients was 0.770.Conclusion Serum P and E2 levels on the transfer day in PCOS infertility patients are correlated with the FET clinical pregnan-cy rate.Elevated P and E2 levels are beneficial for the FET clinical pregnancy rate,and higher E2 levels are also associated with good FET pregnancy outcomes.Serum P and E2 levels on the transfer day have certain predictive value for FET clinical pregnan-cy,and the E2 level on the transfer day can further predict FET pregnancy outcomes.