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Estradiol-to-follicle ratio on human chorionic gonadotropin day is a novel predictor of gestational diabetes mellitus in women receiving fresh embryo transfer

Aims: To assess the predictive value of estradiol (E2) related parameters on the incidence of gestational diabetes mellitus (GDM) in women undergoing fresh embryo transfer. Materials and methods: A Post-hoc analysis of a prospective cohort study. Results: We identified an optimal E2/follicle (E2/F)...

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Main Authors: Chen, Huijun (Author) , Liu, Yvonne (Author) , Xu, Xiangwang (Author) , Hu, Liang (Author) , Cai, Sufen (Author) , Gong, Fei (Author) , Lin, Ge (Author) , Kalk, Philipp (Author) , Krämer, Bernhard (Author) , Hocher, Berthold (Author)
Format: Article (Journal)
Language:English
Published: 11 October 2024
In: Frontiers in endocrinology
Year: 2024, Volume: 15, Pages: 1-9
ISSN:1664-2392
DOI:10.3389/fendo.2024.1465069
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fendo.2024.1465069
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1465069/full
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Author Notes:Huijun Chen, Yvonne Liu, Xiangwang Xu, Liang Hu, Sufen Cai, Fei Gong, Ge Lin, Philipp Kalk, Bernhard K. Krämer and Berthold Hocher
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Summary:Aims: To assess the predictive value of estradiol (E2) related parameters on the incidence of gestational diabetes mellitus (GDM) in women undergoing fresh embryo transfer. Materials and methods: A Post-hoc analysis of a prospective cohort study. Results: We identified an optimal E2/follicle (E2/F) ratio threshold of 246.03 pg/ml on the day of human chorionic gonadotropin (hCG) administration. Women with an E2/F ratio exceeding this threshold had significantly lower rates of GDM (12.75% vs. 20.41%, P < 0.001) and ovarian hyperstimulation syndrome (OHSS) (11.75% vs. 15.48%, P = 0.03). Additional E2 parameters were also evaluated: baseline E2, E2 on hCG day, E2 increase, and E2 fold change. Lower GDM rates were observed in women with baseline E2 above 31.50 pg/ml (13.51% vs. 19.42%, P <0.01), E2 on hCG day above 3794.50 pg/ml (12.26% vs. 19.32%, P < 0.001), and E2 increase above 3771.50 pg/ml (12.24% vs. 19.28%, P < 0.001). There were no significant differences in OHSS rates for these additional E2 parameters. After adjusting for confounders, lower E2/F ratio (OR: 1.626, 95% CI: 1.229-2.150, P <0.01), E2 on hCG day (OR: 1.511, 95% CI: 1.133-2.016, P = 0.01), and E2 increase (OR: 1.522, 95% CI: 1.141-2.031, P <0.01) were identified as risk factors for GDM. Conclusion: This study demonstrates that an E2/F ratio over 246.03 pg/ml is significantly associated with a reduced risk of both GDM and OHSS in women undergoing fresh embryo transfer, highlighting the E2/F ratio as a superior predictive biomarker compared to other E2-related parameters.
Item Description:Gesehen am 02.12.2024
Physical Description:Online Resource
ISSN:1664-2392
DOI:10.3389/fendo.2024.1465069

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