Estradiol serum level on progesterone support day among frozen embryo transfer IVF patients and pregnancy outcomes a systematic review and meta-analysis

Abstract

Introduction: The relationship between estradiol serum levels on the day of progesterone injection and the outcomes of in vitro fertilization (IVF) pregnancies has been extensively explored in various studies and clinical inquiries. This study aims to conduct a systematic review and meta-analysis to investigate the influence of estradiol serum levels on the day of progesterone injection on pregnancy outcomes in IVF cycles. Method: By conducting a thorough search of the PubMed and Embase databases, a total of eight studies were selected for inclusion in the analysis. The results indicated a risk ratio of 1.34 (95% CI 0.85-2.11) for live birth rate, 0.94 (95% CI 0.90-0.99) for biochemical pregnancy rate, 1.02 (95% CI 0.79-1.31) for clinical pregnancy rate, 0.84 (95% CI 0.51-1.41) for miscarriage rate, 0.81 (95% CI 0.49-1.35) for implantation rate, and a mean difference of -0.01 (95% CI -0.35 to 0.33) for endometrial thickness. Results: The study indicates that there is no significant association between progesterone serum levels on the day of hCG administration and IVF pregnancy outcomes. However, the substantial heterogeneity observed across the included studies underscores the necessity for more comprehensive and standardized investigations to uncover the intricate associations between estradiol levels and IVF success. Conclusion: This research enhances our comprehension of the role of estradiol serum levels in IVF outcomes and lays the groundwork for future studies aimed at refining fertility treatment protocols.