{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T21:58:41Z","timestamp":1775771921989,"version":"3.50.1"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T00:00:00Z","timestamp":1589241600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T00:00:00Z","timestamp":1589241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004092","name":"Kuopion Yliopistollinen Sairaala","doi-asserted-by":"publisher","award":["KUH5302463"],"award-info":[{"award-number":["KUH5302463"]}],"id":[{"id":"10.13039\/501100004092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Reprod Biol Endocrinol"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study was made to figure out, does low and high estradiol levels during in vitro fertilization (IVF) cycles have a different effect on carotid artery distensibility (Cdis), carotid artery diameter (Cdia), blood pressure and metabolic factors? Can the stimulation protocol be considered safe to women\u2019s vasculature?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 28 women having a long agonist protocol IVF-treatment in Kuopio University Hospital during the years 2011\u20132016. Patients were examined at three time points: in the beginning of their own period (low estradiol), during the gonadotrophin releasing hormone (GnRH) analogue downregulation (low estradiol) and during the follicle stimulating hormone (FSH) stimulation (high estradiol). Women served as their own controls and their menstrual phase (2- to 5-day period after the beginning of menstruation with low estrogen) was used as the reference. Cdis and Cdia were assessed using ultrasound. Blood pressure, weight, estradiol levels and lipids were monitored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Cdis, Cdia, systolic and diastolic blood pressures peaked during the GnRH-analogue treatment with the lowest estradiol levels. Cdis, Cdia and systolic blood pressures declined by 11% (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002), 3,8% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.001) and 2,5% (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.026) during the FSH-stimulation when the estradiol levels were high. Cdis correlated significantly (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05) with systolic blood pressure, diastolic blood pressure and triglycerides in high estrogenic environment and with diastolic blood pressure (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05) when estrogen profiles were low.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Carotid artery stiffens during the high estradiol levels compared to low levels and this was not explained by the higher diameter of the carotid artery, hyperlipidemia or blood pressure profiles. All the changes in Cdis and Cdia are variations of normal, and if there is no history of cardiovascular problems, it can be considered, that the stimulation protocol is not hazardous to vasculature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12958-020-00608-w","type":"journal-article","created":{"date-parts":[[2020,5,12]],"date-time":"2020-05-12T04:04:22Z","timestamp":1589256262000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The effect of different estradiol levels on carotid artery distensibility during a long agonist IVF protocol"],"prefix":"10.1186","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5201-295X","authenticated-orcid":false,"given":"Jonna","family":"Lepp\u00e4nen","sequence":"first","affiliation":[]},{"given":"Kaisa","family":"Randell","sequence":"additional","affiliation":[]},{"given":"Ursula","family":"Schwab","sequence":"additional","affiliation":[]},{"given":"Jussi","family":"Pihlajam\u00e4ki","sequence":"additional","affiliation":[]},{"given":"Leea","family":"Keski-Nisula","sequence":"additional","affiliation":[]},{"given":"Tomi","family":"Laitinen","sequence":"additional","affiliation":[]},{"given":"Seppo","family":"Heinonen","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2020,5,12]]},"reference":[{"issue":"2","key":"608_CR1","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1111\/j.1748-1716.2005.01505.x","volume":"186","author":"K Hayashi","year":"2006","unstructured":"Hayashi K, Miyachi M, Seno N, Takahashi K, Yamazaki K, Sugawara J, et al. Fluctuations in carotid arterial distensibility during the menstrual cycle do not influence cardiovagal baroreflex sensitivity. Acta Physiol (Oxf). 2006;186(2):103\u201310.","journal-title":"Acta Physiol (Oxf)"},{"key":"608_CR2","unstructured":"Fritz M, Speroff L, editors. Chapter 8. The Endocrinology of Pregnancy. In: Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia: Lippincott, Williams & Wilkins; 2011. p. 276."},{"key":"608_CR3","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/1471-2393-14-98","volume":"14","author":"H K\u00e4rkk\u00e4inen","year":"2014","unstructured":"K\u00e4rkk\u00e4inen H, Saarelainen H, Valtonen P, Laitinen T, Raitakari OT, Juonala M, et al. Carotid artery elasticity decreases during pregnancy - the Cardiovascular Risk in Young Finns study. BMC Pregnancy Childbirth. 2014;14:98.","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"608_CR4","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1042\/CS20040352","volume":"109","author":"B Mersich","year":"2005","unstructured":"Mersich B, Rigo J, Besenyei C, Lenard Z, Studinger P, Kollai M. Opposite changes in carotid versus aortic stiffness during healthy human pregnancy. Clin Sci (Lond). 2005;109(1):103\u20137.","journal-title":"Clin Sci (Lond)"},{"key":"608_CR5","unstructured":"Fritz M, Speroff L, editors. Chapter 17. Menopause and Perimenopausal Transition. In: Clinical gynecologic endocrinology and infertility. 8th ed. Philadelphia: Lippincott, Williams & Wilkins; 2011. p. 690."},{"issue":"1","key":"608_CR6","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/S0002-9149(02)02397-4","volume":"90","author":"MN Bui","year":"2002","unstructured":"Bui MN, Arai AE, Hathaway L, Waclawiw MA, Csako G, Cannon RO. 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