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• W4387396464 abstract "To determine whether increasing peak serum estradiol levels at time of fresh embryo transfer was associated with an increased risk for diagnosis of small for gestational age (SGA) infants at time of delivery. DESIGN: The relationship between elevated serum estradiol levels due to ovarian hyperstimulation for in vitro fertilization (IVF) cycles and SGA infants has been previously described, however recent studies have called this relationship into question. This study hypothesized that when controlling for several important confounders, the relationship between estradiol levels and SGA infants would no longer be present. This institutional review board approved study of data from a large volume IVF center included appropriate deidentified patient and IVF characteristics. Cycles were excluded from analysis if no serum estradiol or infant birth weight was recorded. Final cycle estradiol measurements and total gonadotropin dosing were converted to interquartile ranges for this analysis. SGA diagnosis was made by examining birth weights less than the tenth percentile for gestational age determined by Hadlock equations. Univariate analysis was performed using Chi-Square testing comparing those with the diagnosis of SGA to those without the diagnosis. Log binomial linear modeling was performed on statistically significant associations to determine adjusted odds ratios regarding the risk factor. A p-value of less that 0.05 was considered significant for the purposes of this study. 3076 cycles were included in this study, with 388 (12.9%) meeting criteria for SGA. The mean estradiol level (pg/ml) for all cycles was 2175.78 (SD 1051.25), and interquartile ranges were as follows (25th- 1448, 50th- 2025, and 75th- 2705). Serum estradiol levels were not associated with a diagnosis of SGA (p=0.34). Factors that showed statistically significant differences in diagnosis of SGA infants were maternal age at time of transfer (p<0.01), increasing gravidity and parity (p<0.01), maternal smoking history (0<0.01), male gender of infant (p<0.01), and the type of sperm sample provided for in vitro fertilization (p=0.03). Increasing maternal age and increasing parity were found to be protective against the diagnosis of SGA (p <0.01). Male gender was found to be a significant risk factor for SGA (AOR 1.6, 95% CI 1.32-1.93). Sperm used for fertilization collected by testicular biopsy was also shown to be a significant risk factor (AOR 1.64, 95% CI 1.01-2.65) for SGA. Peak serum estradiol levels were not found to be associated with a diagnosis of SGA in our data set of 3076 patients. Secondary analysis revealed that increasing maternal age and parity were protective against the diagnosis of SGA. Male gender and sperm collected by testicular biopsy showed a significantly increased risk for SGA diagnosis." @default.
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• W4387396464 date "2023-10-01" @default.
• W4387396464 modified "2023-10-07" @default.
• W4387396464 title "AN UPDATED ANALYSIS OF THE ASSOCIATION BETWEEN ESTRADIOL LEVELS AT TIME OF TRANSFER AND SMALL FOR GESTATIONAL AGE INFANTS" @default.
• W4387396464 doi "https://doi.org/10.1016/j.fertnstert.2023.08.447" @default.
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