Estrogen Biosynthesis and Its Regulation in Endometriosis

Xishi Liu, Qiu-Ming Qi, Sun‐Wei Guo
In: Reproductive and Developmental Medicine · 2017 · vol. 1(1) , pp. 55 · doi:10.4103/wkmp-0152.210698 · W4236835543
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Estradiol supplementation as luteal phase support in women with sub-optimal ovarian response undergoing GnRH-ant protocol fresh embryo transfer does not improve clinical pregnancy or live birth rates.

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This retrospective cohort study evaluated whether estradiol supplementation improves reproductive outcomes in women with sub-optimal ovarian response following a gonadotropin-releasing hormone antagonist protocol. The researchers analyzed data from 4992 patients who underwent fresh embryo transfer, comparing those who received estradiol valerate against those who did not after propensity score matching. Results indicated no significant difference in clinical pregnancy or live birth rates between the supplemented and non-supplemented groups. This paper is centrally about endometriosis — specifically laparoscopic excision of deep infiltrating lesions.

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Objective

To evaluate the potential benefits of estradiol (E2) supplementation as luteal phase support (LPS) on reproductive outcomes in women who exhibited sub-optimal or poor ovarian response after a gonadotropin-releasing hormone antagonist (GnRH-ant) protocol and fresh embryo transfer.

Methods

In this retrospective study, we assessed the potential benefits of E2 supplementation as LPS on reproductive outcomes in 4992 women who met the following criteria: 1) age <45 years; 2) use of the GnRH-ant protocol; 3) fewer than 10 collected oocytes; and 4) transfer of an embryo in a fresh cycle between January 2018 and April 2023 at Northwest Women’s and Children’s Hospital. Based on whether the women received E2 supplementation (2 mg E2 valerate tablets twice daily) as LPS after fresh embryo transfer, they were allocated to two groups: non-E2 supplement and E2 supplement. Propensity score matching (1:1 ratio) was applied using multiple covariates known to influence reproductive outcomes. Primary outcomes were the clinical pregnancy and live birth rates.

Results

The clinical pregnancy rate did not significantly differ between the non-E2 supplement and E2 supplement groups (45.89% vs 45.29%, adjusted odds ratio [aOR]: 0.97, 95% confidence interval [CI]: 0.84–1.11, P = 0.615). Similarly, the live birth rate did not significantly differ between groups (36.14% vs 35.43%, aOR: 0.96, 95% CI: 0.83–1.10, P = 0.543).

Conclusions

Our findings suggest that adding E2 supplementation as LPS in women with a sub-optimal or poor response undergoing the GnRH-ant protocol does not improve the clinical pregnancy rate or live birth rate.

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Condition tags

endometriosis

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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