{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:44:40Z","timestamp":1787496280631,"version":"build-2736575974"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"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>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the predictive value of estradiol (E2) related parameters on the incidence of gestational diabetes mellitus (GDM) in women undergoing fresh embryo transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>\n                      A\n                      <jats:italic>Post-hoc<\/jats:italic>\n                      analysis of a prospective cohort study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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 &amp;lt; 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 &amp;lt;0.01), E2 on hCG day above 3794.50 pg\/ml (12.26% vs. 19.32%, P &amp;lt; 0.001), and E2 increase above 3771.50 pg\/ml (12.24% vs. 19.28%, P &amp;lt; 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 &amp;lt;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 &amp;lt;0.01) were identified as risk factors for GDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2024.1465069","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:39:45Z","timestamp":1728607185000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Estradiol-to-follicle ratio on human chorionic gonadotropin day is a novel predictor of gestational diabetes mellitus in women receiving fresh embryo 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