Frontiers in endocrinology · 2026
Association of estradiol and progesterone levels on human chorionic gonadotropin day with pregnancy outcomes in IVF/ICSI fresh embryo transfer.
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Tang Qiaofei, Yi Honggan, Zheng Yantian, Yang Man
Аннотация
OBJECTIVE: This retrospective cohort study investigated the association between estradiol (E2), progesterone (P) levels on human chorionic gonadotropin (HCG) day and the pregnancy outcomes of fresh embryo transfer cycles in In Vitro Fertilization/Intracytoplasmic Sperm Injection (IVF/ICSI) procedures.
METHODS: A retrospective analysis was performed on 1520 cycles from October 2015 to December 2024. The patients were divided into the low and high hormone groups based on the E2 and P levels, and the differences of pregnancy outcomes were compared. Logistic regression analysis was used to investigate the influence of the E2 and P levels on the pregnancy outcomes adjusted for maternal age, paternal age, infertility type, infertility factors, fertilization method, COH protocol, forward motile sperm concentration, and ovarian hyperstimulation syndrome, embryo transfer time, and number of transferred embryos.
RESULTS: Among 1520 cycles, the clinical pregnancy rate was 45.0%, biochemical pregnancy rate 7.7%, and live birth rate 34.9%. The cutoff value of E2 was 2607.0 pg/mL, and P was 0.47 ng/mL based on Restricted Cubic Spline (RCS) analysis. Patients with E2 ≤2607.0 pg/mL and P ≤0.47 ng/mL had significantly higher clinical pregnancy rates but lower biochemical pregnancy rates than those with E2 >2607.0 pg/mL and P >0.47 ng/mL. Logistic regression analysis showed that E2 ≤2607.0 pg/mL (OR: 2.040, 95% CI: 1.627-2.558, p < 0.001), and P ≤0.47 ng/mL (OR: 1.970, 95% CI: 1.539-2.521, p < 0.001) were associated with higher clinical pregnancy rate, while E2 ≤2607.0 pg/mL (OR: 0.573, 95% CI: 0.387-0.848, p = 0.005), and P ≤0.47 ng/mL (OR: 0.455, 95% CI: 0.265-0.781, p = 0.004) were associated with lower biochemical pregnancy rate. The AUCs of E2 and P for predicting clinical pregnancy were 0.570 and 0.579, respectively.
CONCLUSIONS: E2 and P levels on HCG day within the identified threshold range are related to improved clinical pregnancy and reduced biochemical pregnancy in IVF/ICSI fresh embryo transfer cycles.
METHODS: A retrospective analysis was performed on 1520 cycles from October 2015 to December 2024. The patients were divided into the low and high hormone groups based on the E2 and P levels, and the differences of pregnancy outcomes were compared. Logistic regression analysis was used to investigate the influence of the E2 and P levels on the pregnancy outcomes adjusted for maternal age, paternal age, infertility type, infertility factors, fertilization method, COH protocol, forward motile sperm concentration, and ovarian hyperstimulation syndrome, embryo transfer time, and number of transferred embryos.
RESULTS: Among 1520 cycles, the clinical pregnancy rate was 45.0%, biochemical pregnancy rate 7.7%, and live birth rate 34.9%. The cutoff value of E2 was 2607.0 pg/mL, and P was 0.47 ng/mL based on Restricted Cubic Spline (RCS) analysis. Patients with E2 ≤2607.0 pg/mL and P ≤0.47 ng/mL had significantly higher clinical pregnancy rates but lower biochemical pregnancy rates than those with E2 >2607.0 pg/mL and P >0.47 ng/mL. Logistic regression analysis showed that E2 ≤2607.0 pg/mL (OR: 2.040, 95% CI: 1.627-2.558, p < 0.001), and P ≤0.47 ng/mL (OR: 1.970, 95% CI: 1.539-2.521, p < 0.001) were associated with higher clinical pregnancy rate, while E2 ≤2607.0 pg/mL (OR: 0.573, 95% CI: 0.387-0.848, p = 0.005), and P ≤0.47 ng/mL (OR: 0.455, 95% CI: 0.265-0.781, p = 0.004) were associated with lower biochemical pregnancy rate. The AUCs of E2 and P for predicting clinical pregnancy were 0.570 and 0.579, respectively.
CONCLUSIONS: E2 and P levels on HCG day within the identified threshold range are related to improved clinical pregnancy and reduced biochemical pregnancy in IVF/ICSI fresh embryo transfer cycles.