The duration of estrogen treatment before progesterone application does not affect neonatal and perinatal outcomes in frozen embryo transfer cycles

Junwei Zhang; Mingze Du; Zhongkai Wang; Sheling Wu; Yichun Guan; Lijun Sun

doi:10.3389/fendo.2023.988398

The duration of estrogen treatment before progesterone application does not affect neonatal and perinatal outcomes in frozen embryo transfer cycles

Front Endocrinol (Lausanne). 2023 Jul 21:14:988398. doi: 10.3389/fendo.2023.988398. eCollection 2023.

Authors

Junwei Zhang¹, Mingze Du¹, Zhongkai Wang², Sheling Wu¹, Yichun Guan¹, Lijun Sun¹

Affiliations

¹ The Reproductive Center, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.
² Obstetrics and Gynecology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China.

Abstract

Objective: To explore whether the duration of estrogen treatment before progesterone application affects neonatal and perinatal outcomes in artificial frozen embryo transfer (FET) cycles.

Methods: This was a retrospective cohort study. Patients who underwent FET via artificial cycles and delivered a singleton live birth between January 2015 and August 2019 were included in the analysis. According to the duration of estrogen treatment before progesterone application, we divided the cycles into four groups: ①≤12 days, ②13-15 days, ③16-19 days, and ④≥20 days. The '≤12 days group' was considered the reference group. The main outcome measures were preterm birth (PTB), small-for-gestational age (SGA), low birth weight (LBW), macrosomia, large-for-gestational age (LGA), gestational diabetes mellitus (GDM), gestational hypertension, premature rupture and placenta previa.

Results: Overall, 2010 FET cycles with singleton live births were included for analysis. Cycles were allocated to four groups according to the duration of estrogen treatment before progesterone application: ①≤12 days (n=372), ②13-15 days (n=745), ③16-19 days (n=654), ④≥20 days (n=239). The neonatal outcomes, including PTB, SGA, LBW, macrosomia and LGA, were comparable among the groups (P=0.328, P=0.390, P=0.551, P=0.565, P=0.358). The rates of gestational hypertension, premature rupture and placenta previa (P=0.676, P=0.662, P=0.211) were similar among the groups. The rates of GDM among the four groups were 4.0% (15/372), 6.7% (50/745), 6.4% (42/654), and 11.3% (27/239), with statistical significance (P=0.006). After multiple logistic regression analysis, the duration of estrogen treatment did not affect the rate of GDM or other outcomes.

Conclusion: The estrogen treatment duration before progesterone application does not affect neonatal and perinatal outcomes in single frozen blastocyst transfer cycles.

Keywords: artificial cycle; duration of estrogen; frozen embryo transfer; gestational diabetes mellitus; neonatal outcomes.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Embryo Transfer
Estrogens
Female
Fetal Growth Retardation
Fetal Macrosomia
Humans
Hypertension, Pregnancy-Induced*
Infant, Newborn
Placenta Previa*
Pregnancy
Premature Birth* / epidemiology
Progesterone
Retrospective Studies

Substances

Progesterone
Estrogens

Grants and funding

This study was supported by the 2021 Henan Province Medical Science and Technology Research and Joint Construction Project (project nos. LHGJ 20210441 and LHGJ 20210451).