Xiao-Ling Hu1, Chun Feng, Xian-Hua Lin, Zi-Xing Zhong, Yi-Min Zhu, Ping-Ping Lv, Min Lv, Ye Meng, Dan Zhang, Xiu-E Lu, Fan Jin, Jian-Zhong Sheng, Jian Xu, He-Feng Huang. 1. The Key Laboratory of Reproductive Genetics, Ministry of Education (Zhejiang University) (X.-L.H., C.F., X.-H.L., Z.-X.Z., Y.-M.Z., P.-P.L., M.L., Y.M., D.Z., X.-E.L., F.J., J.-Z.S., H.-F.H.), and Department of Reproductive Endocrinology (X.-L.H., C.F., X.-H.L., Z.-X.Z., Y.-M.Z., P.-P.L., M.L., Y.M., D.Z., X.-E.L., F.J., J.X., H.-F.H.), Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310006, China; Department of Pathology and Pathophysiology (J.-Z.S.), School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China; and International Peace Maternity and Child Health Hospital (H.-F.H.), Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
Abstract
CONTEXT: There are increasing concerns that a disrupted endocrine environment may disturb the growth of the fetus. Assisted reproductive technology (ART) situates gamete/embryo in a supraphysiological estradiol (E2) environment and, thus, provides an ideal model to investigate this problem. OBJECTIVE: Our objective was to investigate whether the maternal high-E2 environment in the first trimester increases the risks of low birth weight (LBW) and small-for-gestational-age (SGA) birth. METHODS: In total, 8869 singletons born after fresh embryo transfer (ET) (n = 2610), frozen ET (n = 1039), and natural conception (NC) (n = 5220) and their mothers were included. Birth weight, LBW, SGA, and maternal serum E2 levels were investigated. RESULTS: The mean serum E2 levels of women undergoing fresh ET at 4 and 8 weeks of gestation were significantly higher than those of the women undergoing frozen ET and the women with NC (P < .01). Serum E2 levels of women undergoing fresh ET at 4 and 8 weeks of gestation were positively correlated to those on the day of human chorionic gonadotropin (hCG) administration (r = 0.5 and r = 0.4, respectively; P < 0.01). The birth weight after fresh ET was significantly lower than that after frozen ET and NC (P < 0.01), with increased incidence of LBW and SGA (P < .05). Furthermore, in the fresh ET group, singletons of mothers with high E2 levels (≥10460 pmol/L on the day of hCG administration) had higher risks of LBW (P < .01) and SGA (P < .01) than those with low E2 levels, and maternal serum E2 level on the day of hCG administration negatively correlated with the birth weight (P < .01). CONCLUSIONS: The maternal high-E2 environment in the first trimester is correlated with increased risks of LBW and SGA. Evaluation of serum E2 before ET should be adopted to reduce the possibility of high E2 exposure to gamete/embryo.
CONTEXT: There are increasing concerns that a disrupted endocrine environment may disturb the growth of the fetus. Assisted reproductive technology (ART) situates gamete/embryo in a supraphysiological estradiol (E2) environment and, thus, provides an ideal model to investigate this problem. OBJECTIVE: Our objective was to investigate whether the maternal high-E2 environment in the first trimester increases the risks of low birth weight (LBW) and small-for-gestational-age (SGA) birth. METHODS: In total, 8869 singletons born after fresh embryo transfer (ET) (n = 2610), frozen ET (n = 1039), and natural conception (NC) (n = 5220) and their mothers were included. Birth weight, LBW, SGA, and maternal serum E2 levels were investigated. RESULTS: The mean serum E2 levels of women undergoing fresh ET at 4 and 8 weeks of gestation were significantly higher than those of the women undergoing frozen ET and the women with NC (P < .01). Serum E2 levels of women undergoing fresh ET at 4 and 8 weeks of gestation were positively correlated to those on the day of human chorionic gonadotropin (hCG) administration (r = 0.5 and r = 0.4, respectively; P < 0.01). The birth weight after fresh ET was significantly lower than that after frozen ET and NC (P < 0.01), with increased incidence of LBW and SGA (P < .05). Furthermore, in the fresh ET group, singletons of mothers with high E2 levels (≥10460 pmol/L on the day of hCG administration) had higher risks of LBW (P < .01) and SGA (P < .01) than those with low E2 levels, and maternal serum E2 level on the day of hCG administration negatively correlated with the birth weight (P < .01). CONCLUSIONS: The maternal high-E2 environment in the first trimester is correlated with increased risks of LBW and SGA. Evaluation of serum E2 before ET should be adopted to reduce the possibility of high E2 exposure to gamete/embryo.
Authors: Chloe R McDonald; Andrea L Conroy; Joel L Gamble; Eszter Papp; Michael Hawkes; Peter Olwoch; Paul Natureeba; Moses Kamya; Michael Silverman; Deborah Cohan; Catherine A Koss; Grant Dorsey; Kevin C Kain; Lena Serghides Journal: Clin Infect Dis Date: 2018-01-18 Impact factor: 9.079
Authors: Ning Xu; Gillian M Barlow; Jinrui Cui; Erica T Wang; Bora Lee; Marzieh Akhlaghpour; Lindsay Kroener; John Williams; Jerome I Rotter; Yii-der I Chen; Mark O Goodarzi; Margareta D Pisarska Journal: Reprod Sci Date: 2016-11-14 Impact factor: 3.060
Authors: Barbara Luke; Morton B Brown; Ethan Wantman; Judy E Stern; James P Toner; Charles C Coddington Journal: J Assist Reprod Genet Date: 2016-12-01 Impact factor: 3.412
Authors: Kayode A Balogun; Monica S Guzman Lenis; Eszter Papp; Mona Loutfy; Mark H Yudin; Jay MacGillivray; Sharon L Walmsley; Michael Silverman; Lena Serghides Journal: Clin Infect Dis Date: 2018-01-18 Impact factor: 9.079
Authors: M Pontesilli; M H Hof; A C J Ravelli; A J van Altena; A T Soufan; B W Mol; E H Kostelijk; E Slappendel; D Consten; A E P Cantineau; L A J van der Westerlaken; W van Inzen; J C M Dumoulin; L Ramos; E B Baart; F J M Broekmans; P M Rijnders; M H J M Curfs; S Mastenbroek; S Repping; T J Roseboom; R C Painter Journal: Hum Reprod Date: 2021-05-17 Impact factor: 6.918