Journal of Shandong University (Health Sciences) ›› 2025, Vol. 63 ›› Issue (11): 46-52.doi: 10.6040/j.issn.1671-7554.0.2024.1447

• Clinical Medicine • Previous Articles    

Influence of the duration of estrogen treatment prior to frozen embryo transfer in hormone replacement protocols in endometrial preparation on neonatal birth weight

HAN Xinwei, NIU Yue, WEI Daimin   

  1. Hospital for Reproductive Medicine Affiliated to Shandong University, Jinan 250021, Shandong, China
  • Published:2025-11-28

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Abstract: Objective To investigate the optimal estrogen exposure duration prior to embryo transfer in frozen embryo transfer(FET)cycles with hormone replacement therapy(HRT)for endometrial preparation. Methods This was a retrospective cohort study. Patients who underwent HRT regimen for endometrial preparation before FET and single blastocyst transfer and achieved singleton live birth between 2012 and 2020 were included in the analysis. Overall, 4,577 FET cycles were included for analyses. According to the duration of estrogen treatment before embryo transfer, we divided the cycles into three groups: 12-16 days group(n=1,078), 17-20 days group(n=2,924), and 21-31 days group(n=575). The main outcome measures were neonatal birthweight, and secondary outcomes were gestational diabetes mellitus(GDM), gestational hypertension(HDP), preeclampsia, cesarean section, premature abruption, placenta previa, postpartum hemorrhage, sex of neonates, preterm delivery, small-for-gestational age(SGA), large-for-gestational age(LGA), low birth weight(LBW)and macrosomia. Results There was no significant difference in neonatal birthweight, SGA, LGA, macrosomia among the three groups. The rate of LBW was higher in the 21-31 days group than the 12-16 days group(aOR=1.780, 95%CI: 1.055-3.003, P=0.031). The rates of other pregnancy and neonatal outcomes such as preterm delivery, GDM, HDP, preeclampsia, cesarean section, premature abruption, placenta previa, and postpartum hemorrhage, neonatal outcomes, including sex of neonates were also comparable among the three groups(P>0.05). Conclusion There is no significant difference in birthweight among the three groups, but longer estrogen treatment duration before embryo transfer is associated with a higher rate of LBW in HRT regimen for endometrial preparation before FET. These findings suggest that clinical protocols should individualize estrogen exposure duration based on patient characteristics.

Key words: Frozen embryo, Embryo transfer, Estradiol, Duration of treatment, Pregnancy outcomes

CLC Number: 

  • R714.8
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