IVF/ICSI YAPILAN HASTALARDA GEBELİK VE YENİDOĞAN SONUÇLARININ ÖNGÖRÜLMESİNDE HCG TETİKLEME GÜNÜNDEKİ ESTRADİOL'ÜN DEĞERLENDİRİLMESİ: RETROSPEKTİF KOHORT ÇALIŞMASI

Yıl 2022, Cilt: 19 Sayı: 3, 1431 - 1436, 30.09.2022

Kadriye Erdoğan İnci Kahyaoğlu Serdar Dilbaz İskender Kaplanoğlu Oya Aldemir Ceren Kamacı Emine Utlu Özen Nazlı Tunca Şanlıer

https://doi.org/10.38136/jgon.1106410

Öz

Amaç: Bu çalışmadaki amacımız, insan koryonik gonadotropin (hCG) tetikleme günündeki serum estradiolün (E2) gebelik (canlı doğum ile sonuçlanan gebelik, düşük, iu ex, kimyasal gebelik) sonuçlarını ve yenidoğan doğum ağırlığını tahmin etmedeki rolünü araştırmaktır.
Gereç ve yöntemler: Bu retrospektif çalışma iki gruptan oluşturuldu: Grup 1: 22. gebelik haftasından sonra canlı doğum yapan kadınlardan (n= 417) ve grup 2: Klinik gebelik tanısı konulan kadınlardan (intrauterin ex, abortus, biyokimyasal ve anembriyonik gebelik) (n=260) oluşmaktadır. Demografik özellikler (anne ve baba yaşı, vücut kitle indeksi (VKİ), gravidite, düşük ve yaşayan çocuk) kaydedildi.
Klinik endikasyonlar (erkek faktörü, azalmış over rezervi..), ovulasyon stimülasyon süresi, 3. gün (D3) E2, folikül uyarıcı hormon ve luteinize edici hormon düzeyleri, antral folikül sayısı, stimüle edici ajanların toplam dozları, tetikleme gününde progesteron ve estradiol düzeyleri , toplanan oosit sayısı, matür oosit sayısı, tetikleme ve oosit toplama gününde endometrial kalınlık iki grup arasında karşılaştırıldı. Canlı doğum ile sonuçlanamama riskine etki eden faktörleri belirlemek için Binary Logistic Regresyon, (Backward LR modeli) kullanıldı.
Bulgular: Toplam 677 gebe çalışmaya dahil edildi. Tetikleme gününde E2 düzeyi yüksek olan gebelerde canlı doğum oranı daha yüksek bulundu. Tetikleme günündeki E2 düzeyi ile yenidoğan doğum ağırlığı arasında istatistiksel olarak anlamlı bir ilişki izlendi. (p=0,005). Erkek faktörü ve kadın yaşının canlı doğum ile sonuçlanamama durumunu etkileyen en önemli parametreler olduğu görüldü (p<0.05). Kadın yaşının 1 birim artması ile canlı doğum ile sonuçlanamama riskinin %5 artacağı bulundu.
Sonuç: Tetikleme gününde E2 düzeyi arttıkça, canlı doğum oranı artarken yenidoğan doğum ağırlığı azalmıştır. Erkek faktörü ve kadın yaşının canlı doğum ile sonuçlanamama durumunu etkileyen önemli parametreler olduğu görülmüştür.

Anahtar Kelimeler

Estradiol, in vitro fertilizasyon, gebelik sonuçları, doğum ağırlığı

EVALUATION OF ESTRADIOL ON THE HCG TRIGGER DAY IN PREDICTING PREGNANCY AND NEONATAL OUTCOMES OF PATIENTS UNDERGOING IVF/ICSI: A RETROSPECTIVE COHORT STUDY

Öz

Aim: Our aim was to investigate the value of serum estradiol (E2) on human chorionic gonadotrophin (hCG) trigger day in predicting pregnancy (ongoing pregnancy with live birth, abortion, iu ex, chemical pregnancy) outcomes and neonatal birth weight.
Material-Methods: This retrospective study consisted of two groups: Group 1: Women who had live birth, labor after 22 gestational week (n= 417). Group 2: Women with clinical pregnancy: intrauterine ex, abortus, biochemical and anembryonic pregnancy (n=260).
Demographic characteristics (maternal and paternal ages, body mass index (BMI), gravidity, abortion, and living child) were recorded. Clinical indications (male factor, diminished ovarian reserve...), duration of ovulation stimulation, day 3 (D3) E2, follicle stimulating hormone and luteinizing hormone levels, antral follicle count, total doses of stimulating agents, progesteron and estradiol levels on trigger day, number of oocytes retrieved, number of mature oocytes, endometrial thickness on trigger and oocyte pick-up day were compared between the two groups.
Binary Logistic Regression, (Backward LR model) was used to determine the factors affecting the risk of not having a live birth.
Results: Totally 677 pregnant women were included in the study. We found increased live birth rate in pregnant whom E2 level was higher on the trigger day. There was a statistically significant relation between E2 level on trigger day and newborn weight in live birth (p=0.005) It was determined that the male factor and age of the women are an important parameter that affect not having a live birth (p<0.05). When the age of the woman increases by 1 unit, the risk of not having a live birth will increase by 5%.
Conclusion: The E2 level on hCG trigger day increased, the live birth rate increased while the newborn birth weight decreased. It was also determined that the male factor and age of the women are an important parameter that affect not having a live birth.

Anahtar Kelimeler

Estradiol, in vitro fertilization, pregnancy outcomes, birth weight

Kaynakça

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