Skip to main content

ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Reproduction
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1465069

Estradiol-to-Follicle Ratio on human chorionic gonadotropin (hCG) Day is a novel Predictor of Gestational Diabetes Mellitus (GDM) in Women receiving fresh Embryo Transfer

Provisionally accepted
Huijun Chen Huijun Chen 1,2Yvonne Liu Yvonne Liu 2Xiangwang Xu Xiangwang Xu 1LIANG HU LIANG HU 1Sufen Cai Sufen Cai 1Fei Gong Fei Gong 1Ge Lin Ge Lin 1Philipp Kalk Philipp Kalk 2Bernhard Krämer Bernhard Krämer 3Berthold Hocher Berthold Hocher 3*
  • 1 Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, China
  • 2 Charité University Medicine Berlin, Berlin, Baden-Wurttemberg, Germany
  • 3 Heidelberg University, Heidelberg, Baden-Württemberg, Germany

The final, formatted version of the article will be published soon.

    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.A Post-hoc analysis of a prospective cohort study.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.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: Estradiol: follicle ratio, GDM, predictor, IVF, pregnancy outcomes

    Received: 15 Jul 2024; Accepted: 25 Sep 2024.

    Copyright: © 2024 Chen, Liu, Xu, HU, Cai, Gong, Lin, Kalk, Krämer and Hocher. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Berthold Hocher, Heidelberg University, Heidelberg, 69117, Baden-Württemberg, Germany

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.