Purpose

The objective of this systematic review and metaanalysis was to examine if the probability of pregnancy after ovarian stimulation for in vitro fertilization (IVF), using GnRH analogues and gonadotrophins is associated with serum estradiol level (Ε₂) on the day of triggering final oocyte maturation with human chorionic gonadotrophin (hCG).

Methods

Twenty-one studies were eligible for this systematic review, including 19,598 IVF cycles, whereas three studies were eligible for metaanalysis, including 641 IVF cycles. The main outcome measure was achievement of ongoing pregnancy/live birth and, if not available, clinical pregnancy or biochemical pregnancy.

Results

Pooling of data showed no differences in the probability of clinical pregnancy between patients with high and low Ε₂ levels on the day of triggering final oocyte maturation. The pooled effect sizes for the Ε₂ thresholds groups constructed, regarding clinical pregnancy were 2000–3000 pg/mL—OR 0.91, 95% CI 0.55 to 1.50, (fair quality/moderate risk of bias, n = 1 study), 3000–4000 pg/mL—OR 0.89, 95% CI 0.46 to 1.70, (fair quality/moderate risk of bias, n = 1 study, good quality/no information on which to base a judgement about risk of bias n = 2 studies), 4000–5000 pg/mL—OR 0.74, 95% CI 0.37 to 1.49 fair quality/moderate risk of bias, n = 1 study), 5000–6000 pg/mL—OR 0.62, 95% CI 0.19 to 1.98, (fair quality/moderate risk of bias, n = 1 study). In addition, no difference was observed in the probability of ongoing pregnancy for the Ε₂ threshold group of 3000–4000 pg/mL OR 0.85, 95% CI 0.40 to 1.81(good quality/no information on which to base a judgement about risk of bias, n = 1 study).

Conclusion

Currently, there is insufficient evidence to support or deny the presence of an association between the probability of pregnancy and serum Ε₂ levels on the day of triggering final oocyte maturation with hCG in women undergoing ovarian stimulation for IVF.

中文翻译：

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促卵母细胞最终促成卵母细胞成熟时，IVF卵巢刺激后怀孕的概率与血清雌二醇水平有关吗？系统的审查和荟萃分析。

目的

本系统综述和荟萃分析的目标是检查是否怀孕的概率卵巢刺激后在体外授精（IVF），使用GnRH类似物和促性腺激素与血清雌二醇水平相关（Ε ₂上触发了最终卵母细胞成熟的天）与人类绒毛膜促性腺激素（hCG）。

方法

有21项研究符合此系统评价的条件，包括19,598个IVF周期，而3项研究符合Meta分析的条件，包括641个IVF周期。主要结局指标是持续妊娠/活产的成就，以及如果无法获得临床妊娠或生化妊娠的成就。

结果

数据汇总显示，在触发最终卵母细胞成熟的当天，具有高和低E ₂水平的患者之间临床妊娠的可能性没有差异。汇集效果大小为Ε ₂阈值组构成，关于临床妊娠为2000-3000皮克/毫升-OR 0.91,95％CI 0.55至1.50，（公平质量/偏压的中度风险，Ñ  = 1项研究），3000- 4000 pg / mL-或0.89，95％CI为0.46至1.70（（中等质量/中等偏倚风险，n  = 1研究，高质量/无信息可作为偏倚风险判断的依据，n  = 2研究）， 4000-5000 pg / mL-或0.74，95％CI 0.37至1.49中等质量/中等偏倚风险，n = 1项研究），5000-6000 pg / mL-或0.62，95％CI 0.19至1.98（中等质量/中等偏倚风险，n  = 1项研究）。此外，对于EF ₂阈值组3000–4000 pg / mL或0.85，95％CI 0.40至1.81 ，继续妊娠的可能性没有观察到（良好的质量/没有信息可作为风险的判断依据。偏倚，n  = 1研究）。

结论

目前，没有足够的证据支持或否认在接受IVF卵巢刺激的妇女中，hCG触发最终卵母细胞成熟时，怀孕的机率与血清E ₂水平之间存在关联。