{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:23:58Z","timestamp":1789399438292,"version":"build-2803163510"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T00:00:00Z","timestamp":1651536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To retrospectively analyze the association of serum estradiol (E2) levels on human chorionic gonadotropin (hCG) trigger day and live birth rates (LBRs) in women undergoing fresh embryo transfer and not exhibiting polycystic ovary syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analysis of 13,950 patients who had fresh embryo transfer between December 2013 and December 2019. The main outcome measurement was LBRs. Multivariable regression analysis was performed to investigate associations between E2 levels on the hCG trigger day and LBRs. Stratification analysis was performed to test for effect modification in subgroups. Furthermore, a two-piecewise linear regression model was established to find nonlinear relationships.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multivariable regression analysis showed a significant association between serum E2 levels on the hCG trigger day and LBRs, adjusting for covariates [relative risk (RR) 1.027, 95% confidence interval (CI) 1.007, 1.049]. Stratification analysis showed that the LBRs were positively associated (RR 1.052, 95% CI 1.004, 1.102) with every 1 ng\/ml increase of serum E2 on the hCG trigger day for the subgroup with low antral follicle counts on the trigger day. Specifically, a two-piecewise linear regression model showed that there was a positive association (RR 1.188, 95% CI 1.057, 1.334) between serum E2 and LBR for every increase of 1 ng\/ml E2 when the concentration of serum E2 was lower than 2.1 ng\/ml. However, there was no significant association (RR 1.002, 95% CI 0.971, 1.032) between E2 levels and LBRs when the concentration of E2 was higher than the 2.1ng\/ml inflection point.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Serum E2 levels on the hCG trigger day were segmentally connected with LBRs.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2022.839773","type":"journal-article","created":{"date-parts":[[2022,5,3]],"date-time":"2022-05-03T11:38:33Z","timestamp":1651577913000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["The Association Between Serum Estradiol Levels on hCG Trigger Day and Live Birth Rates in Non-PCOS Patients: A Retrospective Cohort Study"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoyuan","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimin","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guimin","family":"Hao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,5,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1016\/j.beem.2019.01.004","article-title":"Assisted Reproductive Technology: Impact on Society and Need for Surveillance","volume":"33","author":"De Geyter","year":"2019","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/dmt014","article-title":"Progesterone Elevation and Probability of Pregnancy After IVF: A Systematic Review and Meta-Analysis of Over 60 000 Cycles","volume":"19","author":"Venetis","year":"2013","journal-title":"Hum Reprod Update"},{"key":"B3","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s10815-013-0117-8","article-title":"The Impact of Supraphysiologic Serum Estradiol Levels on Peri-Implantation Embryo Development and Early Pregnancy Outcome Following In Vitro Fertilization Cycles","volume":"31","author":"Imudia","year":"2014","journal-title":"J Assist Reprod Gen"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0099423","article-title":"Effects of 5\u03b1-Dihydrotestosterone and 17\u03b2-Estradiol on the Mouse Ovarian Follicle Development and Oocyte Maturation","volume":"9","author":"Tarumi","year":"2014","journal-title":"PloS One"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.humrep.a136313","article-title":"Clinical Evidence for a Detrimental Effect on Uterine Receptivity of High Serum Oestradiol Concentrations in High and Normal Responder Patients","volume":"10","author":"Sim\u00f3n","year":"1995","journal-title":"Hum Reprod"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/15.2.250","article-title":"High Serum Oestradiol Concentrations in Fresh IVF Cycles Do Not Impair Implantation and Pregnancy Rates in Subsequent Frozen-Thawed Embryo Transfer Cycles","volume":"15","author":"Yu","year":"2000","journal-title":"Hum Reprod"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1023\/a:1023670010031","article-title":"Oocyte and Embryo Quality in Patients With Excessive Ovarian Response During In Vitro Fertilization Treatment","volume":"20","author":"Ng","year":"2003","journal-title":"J Assist Reprod Genet"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/bs.vh.2018.01.018","article-title":"The Ovarian Hyperstimulation Syndrome","volume":"107","author":"Blumenfeld","year":"2018","journal-title":"Vitam Horm"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.23736\/S0026-4784.18.04281-8","article-title":"Does Supraphysiologic Estradiol Level During IVF Have Any Effect on Oocyte\/Embryo Quality? 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