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. 2024 Oct 11:15:1465069.
doi: 10.3389/fendo.2024.1465069. eCollection 2024.

Estradiol-to-follicle ratio on human chorionic gonadotropin day is a novel predictor of gestational diabetes mellitus in women receiving fresh embryo transfer

Huijun Chen  1   2 , Yvonne Liu  1   3 , Xiangwang Xu  2 , Liang Hu  2   4 , Sufen Cai  2   4 , Fei Gong  2   4 , Ge Lin  2   4 , Philipp Kalk  1   5 , Bernhard K Krämer  3 , Berthold Hocher  2   3   4   6
Affiliations

Estradiol-to-follicle ratio on human chorionic gonadotropin day is a novel predictor of gestational diabetes mellitus in women receiving fresh embryo transfer

Huijun Chen et al. Front Endocrinol (Lausanne). .

Abstract

Aims: To assess the predictive value of estradiol (E2) related parameters on the incidence of gestational diabetes mellitus (GDM) in women undergoing fresh embryo transfer.

Materials and methods: A Post-hoc analysis of a prospective cohort study.

Results: We identified an optimal E2/follicle (E2/F) ratio threshold of 246.03 pg/ml on the day of human chorionic gonadotropin (hCG) administration. Women with an E2/F ratio exceeding this threshold had significantly lower rates of GDM (12.75% vs. 20.41%, P < 0.001) and ovarian hyperstimulation syndrome (OHSS) (11.75% vs. 15.48%, P = 0.03). Additional E2 parameters were also evaluated: baseline E2, E2 on hCG day, E2 increase, and E2 fold change. Lower GDM rates were observed in women with baseline E2 above 31.50 pg/ml (13.51% vs. 19.42%, P <0.01), E2 on hCG day above 3794.50 pg/ml (12.26% vs. 19.32%, P < 0.001), and E2 increase above 3771.50 pg/ml (12.24% vs. 19.28%, P < 0.001). There were no significant differences in OHSS rates for these additional E2 parameters. After adjusting for confounders, lower E2/F ratio (OR: 1.626, 95% CI: 1.229-2.150, P <0.01), E2 on hCG day (OR: 1.511, 95% CI: 1.133-2.016, P = 0.01), and E2 increase (OR: 1.522, 95% CI: 1.141-2.031, P <0.01) were identified as risk factors for GDM.

Conclusion: This study demonstrates that an E2/F ratio over 246.03 pg/ml is significantly associated with a reduced risk of both GDM and OHSS in women undergoing fresh embryo transfer, highlighting the E2/F ratio as a superior predictive biomarker compared to other E2-related parameters.

Keywords: GDM; IVF; estradiol: follicle ratio; predictor; pregnancy outcomes.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The GDM and OHSS rate in participants. OHSS, ovarian hyperstimulation syndrome. GDM, gestational diabetes mellitus. * represents P value < 0.05.
See this image and copyright information in PMC

References

    1. McIntyre HD, Catalano P, Zhang C, Desoye G, Mathiesen ER, Damm P. Gestational diabetes mellitus. Nat Rev Dis Primers. (2019) 5:47. doi: 10.1038/s41572-019-0098-8 - DOI - PubMed
    1. Solomon CG, Willett WC, Carey VJ, Rich-Edwards J, Hunter DJ, Colditz GA, et al. . A prospective study of pregravid determinants of gestational diabetes mellitus. JAMA. (1997) 278:1078–83. doi: 10.1001/jama.1997.03550130052036 - DOI - PubMed
    1. Zhang C, Ning Y. Effect of dietary and lifestyle factors on the risk of gestational diabetes: review of epidemiologic evidence. Am J Clin Nutr. (2011) 94:1975S–9S. doi: 10.3945/ajcn.110.001032 - DOI - PMC - PubMed
    1. Bao W, Michels KB, Tobias DK, Li S, Chavarro JE, Gaskins AJ, et al. . Parental smoking during pregnancy and the risk of gestational diabetes in the daughter. Int J Epidemiol. (2016) 45:160–9. doi: 10.1093/ije/dyv334 - DOI - PMC - PubMed
    1. Chen L, Hu FB, Yeung E, Willett W, Zhang C. Prospective study of pre-gravid sugar-sweetened beverage consumption and the risk of gestational diabetes mellitus. Diabetes Care. (2009) 32:2236–41. doi: 10.2337/dc09-0866 - DOI - PMC - PubMed

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