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Extremely high estrogen levels may underlie complications of single-birth IVF pregnancies
Date:2/25/2013

ies in a way that leads to the growth and maturation of several eggs at the same time. Prior to ovulation the eggs are retrieved for fertilization outside the mother's body. If fertilization is successful, embryos that appear to be developing normally are transferred into the woman's uterus within 5 days of egg retrieval in a process called fresh embryo transfer.

Egg cells grow and mature in ovarian sacs called follicles, which release estrogen, so the development of multiple maturing follicles can lead to significantly elevated estrogen levels. Animal studies have suggested that excessively elevated estrogen early in pregnancy can interfere with the development of the placenta, and other research has associated placental abnormalities with increased risk for both preeclampsia and delivery of small newborns.

In the June 2012 issue of Fertility and Sterility, the MGH team reported that among almost 300 IVF pregnancies that resulted in the birth of a single infant from 2005 through 2010 the women whose estrogen levels right before egg retrieval were highest had significantly greater incidence of preeclampsia and of delivering infants small for their gestational age. Women whose peak estrogen levels were at or above the 90th percentile had a nine-fold greater risk of a small infant and a five-fold greater risk of preeclampsia than women with lower peak estrogen levels.

To follow up that observation, the MGH team examined how a protocol instituted for mothers at risk of a complication of fertility treatment called ovarian hyperstimulation syndrome (OHSS) might affect the apparent risks associated with extremely high estrogen levels. At the MGH Fertility Center, if the estrogen levels for IVF patients exceed 4,500 pg/mL on the day they are scheduled to receive a hormonal trigger of final egg cell maturation indicating increased risk for OHSS standard practice is to counsel patients on alternatives. These included postpon
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Contact: Colleen Marshall
cmarshall3@partners.org
617-726-0275
Massachusetts General Hospital
Source:Eurekalert

Page: 1 2 3

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