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Yıl 2013, Cilt: 26 Sayı: 3, 122 - 126, 30.09.2015

Tevfik Yoldemir

Öz

Objective: To determine, from a single cohort of patients whether on the day of the human chorionic gonadotropin (hCG) injection, two different cut-off levels for high serum estradiol (E2) levels affect pregnancy rates in long-down regulated assisted reproductive technology (ART) cycles. Patients and Methods: A retrospective cohort analysis was performed in a University affiliated hospital on 539 women undergoing consecutive in vitro fertilization/intacytoplasmic sperm injection (IVF/ICSI) treatment with long-down regulation and recombinant follicular stimulating hormone (FSH) injections. The cut-off level for high E2 concentration was calculated according to a centile analysis of E2 levels on the day of hCG administration. Women in group 1 were divided into subgroup A with E2 levels from the 25th to 75th centiles (1040-2500pg/ml) and subgroup B with E2 levels from the 75th to 100th centiles (>2500pg/ml), respectively. Women in group 2 were divided into subgroup A with E2 levels from the 10th to 90th centile (650-3100pg/ml) and subgroup B with E2 levels from the 90th to 100th centile (>3100pg/ml), respectively. The clinical pregnancy rates and ongoing pregnancy rates were compared. Results: The clinical pregnancy rates and ongoing pregnancy rates were similar in group 1 and group 2. Conclusion: High serum E2 levels on the day of the hCG injection day either set at 75th (2500pg/ml) or 90th percentiles (3100pg/ml) do not compromise pregnancy rates in cycles downregulated with gonadotropin-releasing hormone (GnRH) analogues.

Anahtar Kelimeler

Gonadotropin-releasing analogue Human chorionic gonadotropin Pregnancy long analogue cycle Estradiol

Kaynakça

  • 1. Simon C, Garcia Velasco JJ, Valbuena D, et al. Increasing uterine receptivity by decreasing estradiol levels during the preimplantation period in high responders with the use of a follicle stimulating hormone step-down regimen. Fertil Steril 1998; 70: 234–9. doi.org/10.1016/ S0015-0282(98)00140-X.
  • 2. Pellicer A, Valbuena D, Cano F, Remohi J, Simon C. Lower implantation rates in high responders: Evidence for an altered endocrine milieu during the preimplantation period. Fertil Steril 1996; 65: 1190–5.
  • 3. Simon C, Cano F, Valbuena D, Remohi J, Pellicer A. Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Hum Reprod 1995; 9: 2432–7. doi:10.1093/oxfordjournals.humrep.a136313.
  • 4. Toner JP, Brzyski RG, Oehninger S, Veeck LL, Simonetti S, Muasher SJ. Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome. Hum Reprod 1991; 6: 284–9.
  • 5. Yoldemir T, Fraser IS. The effect of elevated serum estradiol levels on the day of human chorionic gonadotropin injection on pregnancy outcomes in an assisted reproduction program Aust N Z J Obstet Gynaecol 2009; 49: 545–50. doi: 10.1111/j.1479-828X.2009.01061.x.
  • 6. Garcia JE, Acosta AA, Hsiu JG, Jones HW Jr. Advanced endometrial maturation after ovulation induction with human menopausal gonadotropin/human chorionic gonadotropinfor in vitro fertilization. Fertil Steril 1984; 41: 31–5.
  • 7. Kolb BA, Paulson RJ. The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of hyperstimulation on embryo implantation. Am J Obstet Gynecol 1997; 176: 1262–9. doi: 10.1016/S0002-9378(97)70344-2.
  • 8. O’Neill C, Ferrier AJ, Vaughan J, Sinosich MJ, Saunders DM. Causes of implantation failure after in-vitro fertilization and embryo transfer. Lancet 1985; 2: 615. doi:10.1016/S0140-6736(85)90615-4.
  • 9. Check JH, Choe JK, Katsoff D, Summers-Chase D, Wilson C. Controlled ovarian hyperstimulation adversely impacts implantation following in vitro fertilization-embryo transfer. J Assist Reprod Genet 1999; 16: 416–20. doi:10.1023/A:1020565408018.
  • 10. Levi AJ, Drews MR, Bergh PA, Miller BT, Scott RT. Controlled ovarian hyperstimulation does not adversely affect endometrial receptivity in in vitro fertilization cycles. Fertil Steril 2001; 76: 670–4. doi.org/10.1016/S0015-0282(01)01988-4.
  • 11. Yu Ng EH, Yeung WS, Yee Lan Lau E, So WW, Ho PC. High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cases. Hum Reprod 2000; 15: 250–5.
  • 12. Chenette PE, Sauer MV, Paulson RJ. Very high serum E2 levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril 1990; 54:858–63.
  • 13. Gelety TJ, Buyalos RP The influence of supraphysiologic E2 levels on human nidation. J Assist Reprod Genet 1995; 12:406–12. doi: 10.1007/BF02211139.
  • 14. Paulson RJ, Sauer MV, Lobo RA. Factors affecting embryo implantation after human in vitro fertilization: A hypothesis. Am J Obstet Gynecol 1990; 163: 2020–23. doi.org/10.1016/0002-9378(90)90790-E,
  • 15. Valbuena D, Martin J, de Pablo JL, Remohi J, Pellicer A, Simon C. Increasing levels of E2 are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril 2001; 76:962–8. doi: 10.1016/S0015-0282(01)02018-0,
  • 16. Hadi FH, Chantler E, Anderson E, et al. Ovulation induction and endometrial steroid receptors. Hum Reprod 1994; 9: 2405-10.
  • 17. Yoldemir T. The effect of prolonged time for achieving ovarian suppression before starting stimulation on pregnancy rates in ART cycles. Marmara Med J 2013;26:77-81. doi: 10.5472/ MMJ.2013.02650.1.
  • 18. Kosmas IP, Kolibianakis EM, Devroey P. Association of estradiol levels on the day of hCG administration and pregnancy achievement in IVF: a systematic review Human Reprod 2004:19:2446–53. doi:10.1093/humrep/deh473.
  • 19. Clark L, Stanger J, Brinsmead M. Prolonged follicle stimulation decreases pregnancy rates after in vitro fertilization. Fertil Steril 1991; 55: 1192–4.
  • 20. Kolibianakis EM, Albano C, Camus M, Tournaye H, Van Steirteghem AC, Devroey P. Prolongation of the follicular phase in in vitro fertilization results in a lower ongoing pregnancy rate in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertil Steril 2004; 82:102–7. doi.org/10.1016/j.fertnstert. 2004.01.027.
  • 21. Check JH, Nowroozi K, Chase J, Nazari A, Braithwaite C. Comparison of pregnancy rates following in vitro fertilizationembryo transfer between the donors and the recipients in a donor oocyte program. J Assist Reprod Genet 1992; 9: 248–50. doi: 10.1007/BF01203822.
  • 22. Ben-Nun I, Jaffe R, Fejgin MD, Beyth Y. Therapeutic maturation of endometrium in in vitro fertilization and embryo transfer. Fertil Steril 1992; 57: 953–62.
  • 23. Rogers PAW, Milne BJ, Trounson AO. A model to show human uterine receptivity and embryo viability following ovarian stimulation for in vitro fertilization. J In Vitro Fert Embryo Transfer 1986; 3: 93–8. doi: 10.1007/BF01139353.
  • 24. Tarin JJ, Sampaio MC, Calatayud C, Castellvi RM, BonillaMusoles F, Pellicer A. Relativity of the concept ‘high responder to gonadotrophins’. Hum Reprod 1992; 7: 19–22.
  • 25. Sharara FI, McClamrock HD. High E2 levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril 1999; 72:401–5. doi.org/10.1016/S0015-0282(99)00293-9.
  • 26. Papageorgiou T, Guibert J, Goffinet F, et al. Percentile curves of serum E2 levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high E2 is not detrimental to IVF outcome. Hum Reprod 2002; 17: 2846–50. doi: 10.1093/ humrep/17.11.2846.
  • 27. Chen CH, Zhang X, Barnes R, et al. Relationship between peak serum E2 levels and treatment outcome in in-vitro fertilization cycles after embryo transfer on day 3 or day 5. Fertil Steril 2003; 80:75–9. doi. org/10.1016/S0015-0282(03)00504-1.

Aynı YÜT hasta kohortunda hCG günü oluşturulan iki farklı serum östradiol eşik değerlerinin YÜT gebelikleri üzerine etkileri

Yıl 2013, Cilt: 26 Sayı: 3, 122 - 126, 30.09.2015

Tevfik Yoldemir

Öz

Amaç: Yardımcı üreme teknikleri (YÜT) uygulanan hasta
kohortunda insan koriyonik gonadotropin (hCG) günü
oluşturulan iki farklı serum östradiol (E2) eşik değerlerinin
YÜT gebelikleri üzerine etkilerinin araştırılması.
Hastalar ve Yöntem: Üniversiteye bağlı eğitim hastanesinde
uzun süreli gonadotropin salgılayıcı hormon baskısından sonra
kullanılan rekombinant folikül stimüle edici hormon (FSH) ile
YÜT tedavisi alan 539 ardışık kadın retrospektif analize alınmıştır.
hCG günü alınan serum E2 seviyesinin yüksek eşik değeri persentil
analizine göre yapılmıştır. Grup 1 için serum E2 seviyeleri 25–
75inci persentilde (1040-2500pg/ml)olanlar alt grup A ; serum
E2 seviyeleri 75–100üncü persentilde (>2500pg/ml)olanlar alt
grup B olarak ayrılmıştır. Grup 2 için serum E2 seviyeleri 10–
90ıncı persentilde olanlar(650-3100pg/ml) alt grup A ve serum
E2 seviyeleri 90–100üncü persentilde (>3100pg/ml)olanlar alt
grup B olarak ayrılmıştır. Klinik ve devam eden gebelik oranları
karşılaştırılmıştır.
Bulgular: Hem grup 1’de hem de grup 2’de klinik ve gebelik
oranları benzerdir.
Sonuç: hCG günü serum E2 seviyelerinin eşik değeri 75inci
(2500pg/ml), veya 90ıncı persentil (3100pg/ml) üzerinde olması
GnRH analogları ile baskılanmış uzun protokol YÜT sikluslarında
gebelik oranlarını olumsuz etkilememektedir

Anahtar Kelimeler

Gonadotropin salgılayıcı hormon analogu İnsan korionik gonadotropin Gebelik Uzun analog siklusu Östradiol

Kaynakça

  • 1. Simon C, Garcia Velasco JJ, Valbuena D, et al. Increasing uterine receptivity by decreasing estradiol levels during the preimplantation period in high responders with the use of a follicle stimulating hormone step-down regimen. Fertil Steril 1998; 70: 234–9. doi.org/10.1016/ S0015-0282(98)00140-X.
  • 2. Pellicer A, Valbuena D, Cano F, Remohi J, Simon C. Lower implantation rates in high responders: Evidence for an altered endocrine milieu during the preimplantation period. Fertil Steril 1996; 65: 1190–5.
  • 3. Simon C, Cano F, Valbuena D, Remohi J, Pellicer A. Clinical evidence for a detrimental effect on uterine receptivity of high serum oestradiol concentrations in high and normal responder patients. Hum Reprod 1995; 9: 2432–7. doi:10.1093/oxfordjournals.humrep.a136313.
  • 4. Toner JP, Brzyski RG, Oehninger S, Veeck LL, Simonetti S, Muasher SJ. Combined impact of the number of pre-ovulatory oocytes and cryopreservation on IVF outcome. Hum Reprod 1991; 6: 284–9.
  • 5. Yoldemir T, Fraser IS. The effect of elevated serum estradiol levels on the day of human chorionic gonadotropin injection on pregnancy outcomes in an assisted reproduction program Aust N Z J Obstet Gynaecol 2009; 49: 545–50. doi: 10.1111/j.1479-828X.2009.01061.x.
  • 6. Garcia JE, Acosta AA, Hsiu JG, Jones HW Jr. Advanced endometrial maturation after ovulation induction with human menopausal gonadotropin/human chorionic gonadotropinfor in vitro fertilization. Fertil Steril 1984; 41: 31–5.
  • 7. Kolb BA, Paulson RJ. The luteal phase of cycles utilizing controlled ovarian hyperstimulation and the possible impact of hyperstimulation on embryo implantation. Am J Obstet Gynecol 1997; 176: 1262–9. doi: 10.1016/S0002-9378(97)70344-2.
  • 8. O’Neill C, Ferrier AJ, Vaughan J, Sinosich MJ, Saunders DM. Causes of implantation failure after in-vitro fertilization and embryo transfer. Lancet 1985; 2: 615. doi:10.1016/S0140-6736(85)90615-4.
  • 9. Check JH, Choe JK, Katsoff D, Summers-Chase D, Wilson C. Controlled ovarian hyperstimulation adversely impacts implantation following in vitro fertilization-embryo transfer. J Assist Reprod Genet 1999; 16: 416–20. doi:10.1023/A:1020565408018.
  • 10. Levi AJ, Drews MR, Bergh PA, Miller BT, Scott RT. Controlled ovarian hyperstimulation does not adversely affect endometrial receptivity in in vitro fertilization cycles. Fertil Steril 2001; 76: 670–4. doi.org/10.1016/S0015-0282(01)01988-4.
  • 11. Yu Ng EH, Yeung WS, Yee Lan Lau E, So WW, Ho PC. High serum oestradiol concentrations in fresh IVF cycles do not impair implantation and pregnancy rates in subsequent frozen-thawed embryo transfer cases. Hum Reprod 2000; 15: 250–5.
  • 12. Chenette PE, Sauer MV, Paulson RJ. Very high serum E2 levels are not detrimental to clinical outcome of in vitro fertilization. Fertil Steril 1990; 54:858–63.
  • 13. Gelety TJ, Buyalos RP The influence of supraphysiologic E2 levels on human nidation. J Assist Reprod Genet 1995; 12:406–12. doi: 10.1007/BF02211139.
  • 14. Paulson RJ, Sauer MV, Lobo RA. Factors affecting embryo implantation after human in vitro fertilization: A hypothesis. Am J Obstet Gynecol 1990; 163: 2020–23. doi.org/10.1016/0002-9378(90)90790-E,
  • 15. Valbuena D, Martin J, de Pablo JL, Remohi J, Pellicer A, Simon C. Increasing levels of E2 are deleterious to embryonic implantation because they directly affect the embryo. Fertil Steril 2001; 76:962–8. doi: 10.1016/S0015-0282(01)02018-0,
  • 16. Hadi FH, Chantler E, Anderson E, et al. Ovulation induction and endometrial steroid receptors. Hum Reprod 1994; 9: 2405-10.
  • 17. Yoldemir T. The effect of prolonged time for achieving ovarian suppression before starting stimulation on pregnancy rates in ART cycles. Marmara Med J 2013;26:77-81. doi: 10.5472/ MMJ.2013.02650.1.
  • 18. Kosmas IP, Kolibianakis EM, Devroey P. Association of estradiol levels on the day of hCG administration and pregnancy achievement in IVF: a systematic review Human Reprod 2004:19:2446–53. doi:10.1093/humrep/deh473.
  • 19. Clark L, Stanger J, Brinsmead M. Prolonged follicle stimulation decreases pregnancy rates after in vitro fertilization. Fertil Steril 1991; 55: 1192–4.
  • 20. Kolibianakis EM, Albano C, Camus M, Tournaye H, Van Steirteghem AC, Devroey P. Prolongation of the follicular phase in in vitro fertilization results in a lower ongoing pregnancy rate in cycles stimulated with recombinant follicle-stimulating hormone and gonadotropin-releasing hormone antagonists. Fertil Steril 2004; 82:102–7. doi.org/10.1016/j.fertnstert. 2004.01.027.
  • 21. Check JH, Nowroozi K, Chase J, Nazari A, Braithwaite C. Comparison of pregnancy rates following in vitro fertilizationembryo transfer between the donors and the recipients in a donor oocyte program. J Assist Reprod Genet 1992; 9: 248–50. doi: 10.1007/BF01203822.
  • 22. Ben-Nun I, Jaffe R, Fejgin MD, Beyth Y. Therapeutic maturation of endometrium in in vitro fertilization and embryo transfer. Fertil Steril 1992; 57: 953–62.
  • 23. Rogers PAW, Milne BJ, Trounson AO. A model to show human uterine receptivity and embryo viability following ovarian stimulation for in vitro fertilization. J In Vitro Fert Embryo Transfer 1986; 3: 93–8. doi: 10.1007/BF01139353.
  • 24. Tarin JJ, Sampaio MC, Calatayud C, Castellvi RM, BonillaMusoles F, Pellicer A. Relativity of the concept ‘high responder to gonadotrophins’. Hum Reprod 1992; 7: 19–22.
  • 25. Sharara FI, McClamrock HD. High E2 levels and high oocyte yield are not detrimental to in vitro fertilization outcome. Fertil Steril 1999; 72:401–5. doi.org/10.1016/S0015-0282(99)00293-9.
  • 26. Papageorgiou T, Guibert J, Goffinet F, et al. Percentile curves of serum E2 levels during controlled ovarian stimulation in 905 cycles stimulated with recombinant FSH show that high E2 is not detrimental to IVF outcome. Hum Reprod 2002; 17: 2846–50. doi: 10.1093/ humrep/17.11.2846.
  • 27. Chen CH, Zhang X, Barnes R, et al. Relationship between peak serum E2 levels and treatment outcome in in-vitro fertilization cycles after embryo transfer on day 3 or day 5. Fertil Steril 2003; 80:75–9. doi. org/10.1016/S0015-0282(03)00504-1.
Toplam 27 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Tevfik Yoldemir Bu kişi benim

Yayımlanma Tarihi 30 Eylül 2015
Yayımlandığı Sayı Yıl 2013 Cilt: 26 Sayı: 3

Kaynak Göster

APA Yoldemir, T. (2015). Aynı YÜT hasta kohortunda hCG günü oluşturulan iki farklı serum östradiol eşik değerlerinin YÜT gebelikleri üzerine etkileri. Marmara Medical Journal, 26(3), 122-126.
AMA Yoldemir T. Aynı YÜT hasta kohortunda hCG günü oluşturulan iki farklı serum östradiol eşik değerlerinin YÜT gebelikleri üzerine etkileri. Marmara Med J. Eylül 2015;26(3):122-126.
Chicago Yoldemir, Tevfik. “Aynı YÜT Hasta Kohortunda HCG günü oluşturulan Iki Farklı Serum östradiol eşik değerlerinin YÜT Gebelikleri üzerine Etkileri”. Marmara Medical Journal 26, sy. 3 (Eylül 2015): 122-26.
EndNote Yoldemir T (01 Eylül 2015) Aynı YÜT hasta kohortunda hCG günü oluşturulan iki farklı serum östradiol eşik değerlerinin YÜT gebelikleri üzerine etkileri. Marmara Medical Journal 26 3 122–126.
IEEE T. Yoldemir, “Aynı YÜT hasta kohortunda hCG günü oluşturulan iki farklı serum östradiol eşik değerlerinin YÜT gebelikleri üzerine etkileri”, Marmara Med J, c. 26, sy. 3, ss. 122–126, 2015.
ISNAD Yoldemir, Tevfik. “Aynı YÜT Hasta Kohortunda HCG günü oluşturulan Iki Farklı Serum östradiol eşik değerlerinin YÜT Gebelikleri üzerine Etkileri”. Marmara Medical Journal 26/3 (Eylül 2015), 122-126.
JAMA Yoldemir T. Aynı YÜT hasta kohortunda hCG günü oluşturulan iki farklı serum östradiol eşik değerlerinin YÜT gebelikleri üzerine etkileri. Marmara Med J. 2015;26:122–126.
MLA Yoldemir, Tevfik. “Aynı YÜT Hasta Kohortunda HCG günü oluşturulan Iki Farklı Serum östradiol eşik değerlerinin YÜT Gebelikleri üzerine Etkileri”. Marmara Medical Journal, c. 26, sy. 3, 2015, ss. 122-6.
Vancouver Yoldemir T. Aynı YÜT hasta kohortunda hCG günü oluşturulan iki farklı serum östradiol eşik değerlerinin YÜT gebelikleri üzerine etkileri. Marmara Med J. 2015;26(3):122-6.
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